Keegan Conor, Teljeur Conor, Turner Brian, Thomas Steve
Centre of Health Policy and Management, Trinity College Dublin (TCD), Dublin 2, Ireland.
Health Information and Quality Authority (HIQA), Dublin 7, Ireland.
Eur J Health Econ. 2016 Sep;17(7):823-31. doi: 10.1007/s10198-015-0724-7. Epub 2015 Sep 10.
The determinants of consumer mobility in voluntary health insurance markets providing duplicate cover are not well understood. Consumer mobility can have important implications for competition. Consumers should be price-responsive and be willing to switch insurer in search of the best-value products. Moreover, although theory suggests low-risk consumers are more likely to switch insurer, this process should not be driven by insurers looking to attract low risks.
This study utilizes data on 320,830 VHI healthcare policies due for renewal between August 2013 and June 2014. At the time of renewal, policyholders were categorized as either 'switchers' or 'stayers', and policy information was collected for the prior 12 months. Differences between these groups were assessed by means of logistic regression. The ability of Ireland's risk equalization scheme to account for the relative attractiveness of switchers was also examined.
Policyholders were price sensitive (OR 1.052, p < 0.01), however, price-sensitivity declined with age. Age (OR 0.971; p < 0.01) and hospital utilization (OR 0.977; p < 0.01) were both negatively associated with switching. In line with these findings, switchers were less costly than stayers for the 12 months prior to the switch/renew decision for single person (difference in average cost = €540.64) and multiple-person policies (difference in average cost = €450.74). Some cost differences remain for single-person policies following risk equalization (difference in average cost = €88.12).
Consumers appear price-responsive, which is important for competition provided it is based on correct incentives. Risk equalization payments largely eliminated the profitable status of switchers, although further refinements may be required.
在提供重复保险的自愿医疗保险市场中，消费者流动性的决定因素尚未得到充分理解。消费者流动性可能对竞争产生重要影响。消费者应该对价格敏感，并愿意更换保险公司以寻找最具性价比的产品。此外，尽管理论表明低风险消费者更有可能更换保险公司，但这一过程不应由保险公司寻求吸引低风险人群来驱动。
本研究利用了2013年8月至2014年6月期间到期续保的320,830份自愿医疗保险政策的数据。在续保之时，投保人被分为“更换者”或“留存者”，并收集了前12个月的政策信息。通过逻辑回归评估这些群体之间的差异。还研究了爱尔兰的风险均等化计划解释更换者相对吸引力的能力。
投保人对价格敏感（比值比1.052，p < 0.01），然而，价格敏感性随年龄下降。年龄（比值比0.971；p < 0.01）和住院利用率（比值比0.977；p < 0.01）均与更换呈负相关。与这些发现一致，在做出更换/续保决定前的12个月里，单人保险（平均成本差异 = 540.64欧元）和多人保险政策（平均成本差异 = 450.74欧元）的更换者成本低于留存者。风险均等化后，单人保险政策仍存在一些成本差异（平均成本差异 = 88.12欧元）。
消费者似乎对价格敏感，只要基于正确的激励措施，这对竞争很重要。风险均等化支付在很大程度上消除了更换者的盈利状况，尽管可能需要进一步完善。
