Moral hazard and adverse selection in Australian private hospitals: 1989–1990

Savage, Elizabeth; Wright, Donald J.

doi:10.1016/s0167-6296(02)00104-2

Cited by 100 publications

(84 citation statements)

References 14 publications

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“…Cameron et al (1988), using data for Australia, find that for a broad range of services more generous coverage leads to higher utilization because of both moral hazard and adverse selection. Savage and Wright (2003), also for Australia, find that private insurance increases hospital length of stay. Vera-Hernández (1999), using data for a Spanish region, finds different evidence for heads-of-household than for non-heads-of-household.…”

Section: Review Of the Literaturementioning

confidence: 94%

“…The traditional way of controlling for this potential bias is to use instrumental variables (e.g., Cameron et al, 1988;Coulson et al, 1995;Holly et al, 1998;VeraHernández, 1999;Savage and Wright, 2003). The econometric model used to estimate the impact of insurance on health-care utilization varies substantially in the literature, depending both on the characteristic of the dependent variable (e.g., count or binary) and the convenience of the model.…”

Section: Review Of the Literaturementioning

confidence: 99%

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Moral hazard and the demand for health services: A matching estimator approach

Barros

Machado

Sanz-de-Galdeano

2008

Journal of Health Economics

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JEL classification: C31 I11 Keywords:Demand for health services Matching estimator Moral hazard Portuguese health system a b s t r a c tWe estimate the impact of extra health insurance coverage beyond a National Health System on the demand for several health services. Traditionally, the literature has tried to deal with the endogeneity of the private (extra) insurance decision by finding instrumental variables. Since a priori instrumental variables are hard to find we take a different approach. We focus on the most common health insurance plan in Portugal, ADSE, which is given to all civil servants and their dependents. We argue that this insurance is exogenous, i.e., not correlated with the beneficiaries' health status. This identifying assumption allows us to estimate the impact of having ADSE coverage on the demand for three different health services using a matching estimator technique. The health services used are number of visits, number of blood and urine tests, and the probability of visiting a dentist. Results show large positive effects of ADSE coverage for number of visits and tests among the young (18-30 years old) but only the latter is statistically significantly different from zero. The effects represent 21.8% and 30% of the average number of visits and tests for the young. On the contrary, we find no evidence of moral hazard on the probability of visiting a dentist.

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Section: Review Of the Literaturementioning

confidence: 94%

Section: Review Of the Literaturementioning

confidence: 99%

Moral hazard and the demand for health services: A matching estimator approach

Barros

Machado

Sanz-de-Galdeano

2008

Journal of Health Economics

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“…However, a decrease in health stock due to aging raises hospitalization [2]. Although private health insurers adjust their premiums according to age, the results show a possibility of adverse selection under the national health insurance system [15,20,22].…”

Section: Resultsmentioning

confidence: 99%

“…For moral hazards, Sapelli and Vial (2003) state a negligible case of hospitalization in moral hazard, but they highlight a quantitatively important moral hazard for medical visits in Chile [21]. Savage and Wright (2003) emphasize that moral hazard substantially increase the expected length of a hospital stay in Australia [22], while Kessler (2008) underlines an existence of risk of moral hazard and the long-term care insurance in France [23].…”

Section: Introductionmentioning

confidence: 99%

Private Health Insurance and Hospitalization Under Japanese National Health Insurance

Yamada¹,

Chen²,

Yamada³

et al. 2009

TOECONSJ

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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. We empirically examine how the decision to purchase private health insurance and hospitalization are made based on labor income, socio-demographic factors, and private health insurance. The increase in household labor income and wealth has a positive effect on purchasing private health insurance. This suggests a supplementary effect for public health insurance under the strict control of a two-tier healthcare coverage system. Our results support the hypothesis that moral hazard presents for the costs paid to private health insurance by households. A strong positive association with the risk of hospitalization causes individuals to change their health behavior after purchasing private health insurance leading to lower costs in the ill health status and acquire less preventive measures. Thus, moral hazard exists in Japanese health insurance market. Unlike the previous study, adverse selection based on our results is not negligible in the case of hospitalization in Japan. The positive effect indicates that the higher the risk of illness with households, the more insurance policies a household possesses. The results support our hypotheses that the decision to purchase health insurance in case of death in an insured household in a hospital is attributed to the initial health stock of the household. This means that households purchase private health insurance when there is a high probability of hospitalization with claimed insurance on death. The benefits from private health insurance policies for hospitalization provide incentives for individuals to purchase health insurance that are a reflection of adverse selection against private health insurance. Terms of use: Documents in

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“…This is perhaps not surprising given the variety of identification strategies used. Savage and Wright (2003) and Lu and Savage (2006) consider selection on observables only. Several studies have used instrumental variables to separate causal effects from selection.…”

Section: Background 21 Literature Reviewmentioning

confidence: 99%

Hips and hearts: The variation in incentive effects of insurance across hospital procedures

Doiron

Fiebig

Suziedelyte

2014

Journal of Health Economics

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent School of Economics, University of New South Wales AbstractThe separate identification of effects due to incentives, selection and preference heterogeneity in insurance markets is the topic of much debate. In this paper, we investigate the presence and variation in moral hazard across health care procedures. The key motivating hypothesis is the expectation of larger causal effects in the case of more discretionary procedures. The empirical approach relies on an extremely rich and extensive dataset constructed by linking survey data to administrative data for hospital medical records. Using this approach we are able to provide credible evidence of large moral hazard effects but for elective surgeries only.

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Moral hazard and adverse selection in Australian private hospitals: 1989–1990

Cited by 100 publications

References 14 publications

Moral hazard and the demand for health services: A matching estimator approach

Moral hazard and the demand for health services: A matching estimator approach

Private Health Insurance and Hospitalization Under Japanese National Health Insurance

Hips and hearts: The variation in incentive effects of insurance across hospital procedures

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