School of Economics, Universidad del Rosario, Calle 12 C No. 4 - 69, 111711, Bogotá, Colombia.
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
BMC Health Serv Res. 2022 May 9;22(1):618. doi: 10.1186/s12913-022-07899-2.
Since 1993, Colombia has had a mandatory social health insurance scheme that aims to provide universal health coverage to all citizens. However, some contributory regime participants purchase voluntary private health insurance (VPHI) to access better quality health services (i. e., physicians and hospitals), shorter waiting times, and a more extensive providers' network. This article aims to estimate the price elasticity of demand for the VPHI market in Colombia.
We use data from the 2016-2017 consumer expenditure national survey and apply a Heckman selection model to address the selection problem into purchasing private insurance. Using the estimation results to further estimate the price semi-elasticity for VPHI, we then calculate the price elasticity for the households' health expenditure and acquisition of VHPI.
Our main findings indicate that a 1% VPHI price increase reduces the proportion of households affiliated to a VPHI in the country by about 2.32% to 4.66%, with robust results across sample restrictions. There are relevant differences across age groups, with younger households' heads being less responsive to VPHI price changes.
We conclude that the VPHI demand in Colombia is noticeably elastic, and therefore tax policy changes can have a significant impact on public health insurance expenditures. The government should estimate the optimal VPHI purchase in order to reduce any welfare loss that the current arrangement might be generating.
自 1993 年以来，哥伦比亚实行了强制性的社会健康保险计划，旨在为所有公民提供全民健康覆盖。然而，一些缴费制度的参与者购买自愿私人健康保险（VPHI），以获得更好质量的医疗服务（即医生和医院）、更短的等待时间和更广泛的供应商网络。本文旨在估计哥伦比亚 VPHI 市场的需求价格弹性。
我们使用 2016-2017 年消费者支出全国调查的数据，并应用 Heckman 选择模型来解决购买私人保险的选择问题。利用估计结果进一步估计 VPHI 的价格半弹性，然后计算家庭健康支出和 VHPI 购买的价格弹性。
我们的主要发现表明，VPHI 价格上涨 1%，将全国参加 VPHI 的家庭比例降低约 2.32%至 4.66%，在样本限制下具有稳健的结果。不同年龄组之间存在显著差异，年轻家庭的负责人对 VPHI 价格变化的反应较小。
我们得出结论，哥伦比亚的 VPHI 需求明显具有弹性，因此税收政策的变化可能对公共健康保险支出产生重大影响。政府应估计最优的 VPHI 购买量，以减少当前安排可能产生的任何福利损失。
