Managed competition and consumer price sensitivity in social health insurance

Schut, Erik; Hassink, Wolter

doi:10.1016/s0167-6296(02)00055-3

Cited by 39 publications

(38 citation statements)

References 16 publications

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“…Using data from all sickness funds in the Netherlands, Schut and Hassink (2002) study the effects of a managed competition-based health insurance reform and find out-of-pocket premium elasticities with respect to the market share of -0.3 for compulsory insurance. Discussing differences to the US market comprehensively, the authors conclude that price sensitivity in the US would be much higher due to lower search costs and higher switching experience.…”

Section: Previous Literature On Health Plan Switchingmentioning

confidence: 99%

In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

Schmitz

Ziebarth

2011

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. This series presents research findings based either directly on data from the German SocioEconomic Panel Study (SOEP) or using SOEP data as part of an internationally comparable data set (e.g. CNEF, ECHP, LIS, LWS, CHER/PACO). SOEP is a truly multidisciplinary household panel study covering a wide range of social and behavioral sciences: economics, sociology, psychology, survey methodology, econometrics and applied statistics, educational science, political science, public health, behavioral genetics, demography, geography, and sport science. Terms of use: Documents inThe decision to publish a submission in SOEPpapers is made by a board of editors chosen by the DIW Berlin to represent the wide range of disciplines covered by SOEP. There is no external referee process and papers are either accepted or rejected without revision. Papers appear in this series as works in progress and may also appear elsewhere. They often represent preliminary studies and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be requested from the author directly.Any opinions expressed in this series are those of the author(s) and not those of DIW Berlin.Research disseminated by DIW Berlin may include views on public policy issues, but the institute itself takes no institutional policy positions. December 2011 ‡ We would like to thank John Cawley, Damon Clark, Maria Fitzpatrick, Don Kenkel, Sam Kleiner, Jordan Matsudaira, Emily Owens, Andreas Schmid, and participants in seminars at the University of Duisburg-Essen, FU Berlin, the DIBOGS workshop in Hamburg as well as The Institute on Health Economics, Health Behaviors and Disparities at Cornell University. We take responsibility for all remaining errors in and shortcomings of the article. We also would like to thank Peter Eibich for excellent research assistance and Adam Lederer for excellence in editing this paper. The research reported in this paper is not the result of a for-pay consulting relationship. Our employers do not have a financial interest in the topic of the paper that might constitute a conflict of interest.* University of Schuetzenbahn 70, 45117 Essen, Germany, AbstractThis paper provides field evidence on (a) how price framing affects consumers' decision to switch health insurance plans and (b) how the price elasticity of demand for health insurance can be influenced by policymakers through simple regulatory efforts. In 2009, in o...

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Section: Previous Literature On Health Plan Switchingmentioning

confidence: 99%

In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

Schmitz

Ziebarth

2011

SSRN Journal

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“…Such strategies, however, are effective only if a substantial proportion of the insured is willing to switch (Schut and Hassink, 2002).…”

Section: Usefulness Of Si As a Selection Devicementioning

confidence: 99%

Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets

Paolucci

Schut

Beck

et al. 2007

HEPL

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As the share of supplementary health insurance (SI) in health carefinance is likely to grow, SI may become an increasingly attractive tool for riskselection in basic health insurance (BI). In this paper, we develop a conceptual framework to assess the probability that insurers will use SI for favourable riskselection in BI. We apply our framework to five countries in which risk-selection via SI is feasible: Belgium, Germany, Israel, the Netherlands, and Switzerland. For each country, we review the available evidence of SI being used as selection device. We find that the probability that SI is and will be used for risk-selection substantially varies across countries. Finally, we discuss several strategies for policy makers to reduce the chance that SI will be used for risk-selection in BI markets.

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“…In Italy and Sweden, purchasers and providers of healthcare services were separated in the early 1990s in order to create internal markets (Bjuggren 1998;Freeman 1998;Cellini et al 2000). In the Netherlands, healthcare reforms of the 1990s were strongly influenced by the managed competition model, in which competing health insurers acted as buyers of healthcare services for their members (Schut and Hassink 2002;van de Ven et al 2004). In publicly insured systems such as these, managed competition was instituted in order to promote technical efficiency (i.e., producing the highest level of output from the available resources), while its purpose in the United States has largely been to reduce costs given existing output levels.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Competition on Community-Based Nursing Wages

Zarnett

Coyte²,

Nauenberg³

et al. 2009

hcpol

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Les effets de la concurrence sur les salaires des infirmières en milieu communautaire Dara Zarnett et al. DA R A Z A R N E T T, M S C Department of Health Policy, Management and Evaluation Faculty of Medicine, University of Toronto Toronto, ON P E T E R C . C OY T E , P H D CHSRF/CIHR Chair in Health Care AbstractIn 1997, Ontario implemented a competitive bidding process for purchasing home care services, with the twin objectives of lowering costs and increasing service quality. The authors of this study performed regression analyses to ascertain the relationship between measures of competition, profit status of providers and nursing wages for community-based RNs and LPNs between 1995/1996. Using the Herfindahl-Hirschman Index as a measure of competition, we observed that only RN wages significantly increased as competition in home care increased. Furthermore, for-profit agencies paid significantly lower RN wages than their not-for-profit counterparts. By contrast, LPN wages declined over the sample period and did not differ markedly across provider types. The relative distribution of for-profit and not-forprofit agencies changed dramatically over the study period, with large increases in the number and volume of for-profit contracts. The results indicate that (a) greater competition in the home care sector resulted in upward pressure on RN wages independent of the profit status of the provider and (b) the increase appears to have been constrained by the increased presence of for-profit providers over the study period. The results highlight the role of profit status in provider behaviour, even in the context of publicly funded home care services. This finding has implications for both provider mix and the remuneration of nurses. des infirmières autorisées, et ce, indépendamment du type (avec ou sans but lucratif ) de fournisseur, et que (b) l' augmentation semble freinée par la présence accrue de fournisseurs à but lucratif au cours de la période visée par l' étude. Les résultats font ressortir le rôle du statut (avec ou sans but lucratif ) dans le comportement des fournisseurs, et ce, même dans le contexte des services à domiciles subventionnés par l'État. Ces conclusions ont des répercussions tant pour la composition des types de fournisseurs que pour la rémunération des infirmières. RésuméT S IMILAR TO OTHER HEALTHCARE MARKETS, THE ONTARIO HOME CARE SECTOR has undergone reform in an effort to contain costs and improve the quality of care. In 1997, Ontario embraced competitive strategies in order to encourage the efficient provision of home care that influences both the price and quality of in-home services (Baker 2001). "Managed" competition in healthcare has been introduced in a number of countries as a mechanism to promote innovation, consumer choice, service flexibility, efficiency and responsiveness while ensuring accountability for public spending (Williams et al. 1999). The aim has been to capture features of competitive markets that result in efficient and innovative production by substituting private-...

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Managed competition and consumer price sensitivity in social health insurance

Cited by 39 publications

References 16 publications

In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets

The Effects of Competition on Community-Based Nursing Wages

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