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健康保险补贴与自付额选择:来自补贴计划地区差异的证据。

Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes.

机构信息

University of Lucerne, Department of Health Sciences and Health Policy and Center for Health, Policy and Economics, Frohburgstrasse 3, PO Box 4466, CH-6002 Lucerne, Switzerland.

University of Bern, Department of Economics and CSS Institute for Empirical Health Economics, Tribschenstrasse 21, CH-6002 Lucerne, Switzerland.

出版信息

J Health Econ. 2017 Sep;55:262-273. doi: 10.1016/j.jhealeco.2017.08.002. Epub 2017 Aug 5.

Abstract

The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy. We discuss our results in the light of potential extra-marginal effects on the demand for health care services, which are however not supported by our data.

摘要

保费补贴在多大程度上能够影响医疗保险的选择是一个悬而未决的问题。在本文中,我们探讨了瑞士各地不同的补贴计划形式,包括实物补贴和现金补贴,以研究它们对医疗保险免赔额选择的影响。我们利用健康调查数据和双重差分法发现,实物补贴使选择低免赔额计划的可能性增加了约 4 个百分点(或 7%)。我们的结果表明,实物补贴对女性、中年和未婚个体的反应最强,我们通过风险承担行为、健康状况、财务约束、医疗保险和金融知识方面的差异来解释这一现象。我们根据对医疗服务需求的潜在边际外效应来讨论我们的结果,但我们的数据并不支持这些效应。

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