CPB Netherlands Bureau for Economic Policy Analysis, The Hague, The Netherlands.
Erasmus University Rotterdam, iBMG, Rotterdam, The Netherlands.
Eur J Health Econ. 2017 Nov;18(8):1047-1064. doi: 10.1007/s10198-017-0876-8. Epub 2017 Feb 27.
In this paper we estimate health plan price elasticities and financial switching gains for consumers over a 20-year period in which managed competition was introduced in the Dutch health insurance market. The period is characterized by a major health insurance reform in 2006 to provide health insurers with more incentives and tools to compete, and to provide consumers with a more differentiated choice of products. Prior to the reform, in the period 1995-2005, we find a low number of switchers, between 2 and 4% a year, modest average total switching gains of 2 million euros per year and short-term health plan price elasticities ranging from -0.1 to -0.4. The major reform in 2006 resulted in an all-time high switching rate of 18%, total switching gains of 130 million euros, and a high short-term price elasticity of -5.7. During 2007-2015 switching rates returned to lower levels, between 4 and 8% per year, with total switching gains in the order of 40 million euros per year on average. Total switching gains could have been 10 times higher if all consumers had switched to one of the cheapest plans. We find short-term price elasticities ranging between -0.9 and -2.2. Our estimations suggest substantial consumer inertia throughout the entire period, as we find degrees of choice persistence ranging from about 0.8 to 0.9.
本文在荷兰医疗保险市场引入管理竞争的 20 年间，对消费者的医疗保险价格弹性和金融转换收益进行了估计。这一时期的特点是 2006 年进行了重大医疗保险改革，为保险公司提供了更多的激励和竞争工具，并为消费者提供了更具差异化的产品选择。在改革之前，即 1995-2005 年期间，我们发现转换率较低，每年为 2%至 4%，每年的平均总转换收益为 200 万欧元，短期医疗保险价格弹性在-0.1 至-0.4 之间。2006 年的重大改革导致转换率达到历史最高水平 18%，总转换收益为 1.3 亿欧元，短期价格弹性高达-5.7。2007-2015 年期间，转换率回落到每年 4%至 8%的较低水平，平均每年的总转换收益约为 4000 万欧元。如果所有消费者都转换到最便宜的计划之一，总转换收益本可以高出 10 倍。我们发现短期价格弹性在-0.9 到-2.2 之间。我们的估计表明，整个时期内消费者存在大量的惯性，因为我们发现选择的持续程度在 0.8 到 0.9 之间。
