What is the impact of duplicate coverage on the demand for health care in Germany?

Vargas, MH and Elhewaihi, M (2007): What is the impact of duplicate coverage on the demand for health care in Germany?

Abstract

Duplicate coverage involves those individuals who hold public health insurance, and purchase additional private coverage. Using data from the German Institute for Economic Research, we try to investigate the impact of duplicate coverage on the demand for healthcare (measured in number of visits to doctors). Given the simultaneity of the choices to take out additional private health insurance coverage, we estimate a negative binomial model to measure this impact. We also estimate a a Full Information Maximun Loglikelihood (FIML), known as Endogenous Switching Poisson Count Model and we compare these results with the standard maximum log likelihood (ML) estimators of the negative binomial model. The Results show that, there is a positive difference on the level of health services demanded when there is a duplicate coverage. We found also that there is evidence to think that in Germany there is a feedback between duplicate coverage and the demand of health services.

• Item Type: MPRA Paper
• Language: English
• Keywords: Health care services demand, health insurance
• Subjects: I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets; I - Health, Education, and Welfare > I1 - Health > I10 - General

References

@article{cameron1988mmd, title={{A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia}}, author={Cameron, AC and Trivedi, PK and Milne, F. and Piggott, J.}, journal={The Review of Economic Studies}, volume={55}, number={1}, pages={85--106}, year={1988}, publisher={JSTOR} }

@article{verahernandez1999dca, title={{Duplicate coverage and demand for health care. The case of Catalonia}}, author={Vera-Hernandez, A.M.}, journal={Health Economics}, volume={8}, number={7}, pages={579--598}, year={1999} }

@book{colombo2004phi, title={{Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems}}, author={Colombo, F. and Tapay, N. and Labour and Social Affairs Committee Employment and Organisation for Economic Co-operation and Development}, year={2004}, publisher={Organisation for Economic Co-operation and Development, Directorate for Employment, Labour and Social Affaires, Employment, Labour and Social Affairs Committee} }

@book{busse2004hcs, title={{Health Care Systems in Transition.}}, author={Busse, R. and Riesberg, A.}, year={2004}, publisher={WHO Regional Officce for Europe on behalf of the European Observatory on Health Care Systems and Policies} }

@book{rohweder1996nnk, title={{Nachfrage nach Krankenversicherung: Eine Untersuchung des Wahlverhaltens der freiwillig Versicherten in Deutschland}}, author={Rohweder, J.P.}, year={1996}, publisher={VVW} }

@article{windmeijer1997ecd, title={{Endogeneity in Count Data Models: An Application to Demand for Health Care}}, author={Windmeijer, F.A.G. and Santos Silva, J.M.C.}, journal={Journal of Applied Econometrics}, volume={12}, number={3}, pages={281--294}, year={1997}, publisher={John Wiley \& Sons} }

@article{grogger1990ste, title={{A simple test for exogeneity in probit, logit and Poisson regression models}}, author={Grogger, J.}, journal={Economics Letters}, volume={33}, number={4}, pages={329--332}, year={1990} }

@article{arrow53jua, title={{“Uncertainty and the Welfare Economics of Medical Care,”}}, author={Arrow, K.J.}, journal={American Economic Review}, volume={53}, number={5}, year={1963}, pages={941--73} }

@article{grossman1972chc, title={{On the Concept of Health Capital and the Demand for Health}}, author={Grossman, M.}, journal={The Journal of Political Economy}, volume={80}, number={2}, pages={223--255}, year={1972}, publisher={JSTOR} }

@article{jochmann2004edh, title={{Estimating the Demand for Health Care with Panel Data: A Semiparametric Bayesian Approach}}, author={Jochmann, M. and Leon-Gonzalez, R.}, journal={Health Economics}, volume={13}, number={10}, pages={1003--1014}, year={2004} }

@article{liljas1998dhu, title={{The demand for health with uncertainty and insurance.}}, author={Liljas, B.}, journal={J Health Econ}, volume={17}, number={2}, pages={153--70}, year={1998} }

@article{grossman2004dhy, title={{The demand for health, 30 years later: a very personal retrospective and prospective reflection}}, author={Grossman, M.}, journal={Journal of Health Economics}, volume={23}, number={4}, pages={629--636}, year={2004}, publisher={Elsevier} }

@article{deb1997dmc, title={{Demand for Medical Care by the Elderly: A Finite Mixture Approach}}, author={Deb, P. and Trivedi, P.K.}, journal={Journal of Applied Econometrics}, volume={12}, number={3}, pages={313--336}, year={1997}, publisher={John Wiley \& Sons} }

@article{geil1997eia, title={{Economic Incentives and Hospitalization in Germany}}, author={Geil, P. and Million, A. and Rotte, R. and Zimmermann, K.F.}, journal={Journal of Applied Econometrics}, volume={12}, number={3}, pages={295--311}, year={1997}, publisher={John Wiley \& Sons} }

@article{pohlmeier1995emt, title={{An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care}}, author={Pohlmeier, W. and Ulrich, V.}, journal={The Journal of Human Resources}, volume={30}, number={2}, pages={339--361}, year={1995}, publisher={JSTOR} }

@article{glied2001hia, title={{Health Insurance and Market Failure since Arrow}}, author={Glied, S.A.}, journal={Journal of Health Politics, Policy and Law}, volume={26}, number={5}, pages={957--966}, year={2001}, publisher={Duke Univ Press} }

@article{millenson2001mhv, title={{Moral Hazard vs. Real Hazard: Quality of Care Post-Arrow}}, author={Millenson, M.L.}, journal={Journal of Health Politics, Policy and Law}, volume={26}, number={5}, pages={1069--1080}, year={2001}, publisher={Duke Univ Press} }

@article{riphahn2003ied, title={{Incentive effects in the demand for health care: a bivariate panel count data estimation}}, author={Riphahn, R.T. and Wambach, A. and Million, A.}, journal={Journal of Applied Econometrics}, volume={18}, number={4}, pages={387--405}, year={2003} }

@misc{derprivatenkrankenversicherung2000phi, title={{Private health insurance: facts and figures 1999/2000}}, author={der privaten Krankenversicherung, V.}, year={2000}, publisher={Cologne, PKV} }

@article{terza1998ecd, title={{Estimating count data models with endogenous switching: Sample selection and endogenous treatment effects}}, author={Terza, J.V.}, journal={Journal of Econometrics}, volume={84}, number={1}, pages={129--154}, year={1998}, publisher={Elsevier} }

@article{romeu2005ceb, title={{Counts with an endogenous binary regressor: A series expansion approach}}, author={Romeu, A. and Vera-Hernandez, M.}, journal={The Econometrics Journal}, volume={8}, number={1}, pages={1--22}, year={2005}, publisher={Blackwell Synergy} }

@book{schellhorn2001cam, title={{A Comparison of Alternative Methods to Model Endogeneity in Count Models: An Application to the Demand for Health Care and Health Insurance Choice}}, author={Schellhorn, M.}, year={2001}, publisher={SEDAP Research Program} }

@article{terza1998ecd, title={{Estimating count data models with endogenous switching: Sample selection and endogenous treatment effects}}, author={Terza, J.V.}, journal={Journal of Econometrics}, volume={84}, number={1}, pages={129--154}, year={1998}, publisher={Elsevier}}

@article{terza2007cam, title={{Two-Stage Residual Inclusion Estimation: Addressing Endogeneity in Health Econometric Modeling}}, author={Terza, J.V. and Basu, A. and Rathouz P.J.}, journal={Journal of Health Economics}, year={2007}, }

@article{kenkel2001epa, title={{The Effect of Physician Advice on Alcohol Consumption: Count Regression with an Endogenous Treatment Effect}}, author={Kenkel, D.S. and Terza, J.V.}, journal={Journal of Applied Econometrics}, volume={16}, number={2}, pages={165--184}, year={2001}, publisher={John Wiley \& Sons} }

@article{dardanoni1990uad, title={{Uncertainty and the demand for medical care.}}, author={Dardanoni, V. and Wagstaff, A.}, journal={Journal of Health Economics}, volume={9}, pages={23--38}, year={1990} }

@article{gataykocc2004eud, title={{The Effects of Uncertainty on the Demand for Health Insurance}}, author={g atay Ko{\c{c}}, {\c{C}}.}, journal={The Journal of Risk and Insurance}, volume={71}, number={1}, pages={41}, year={2004}, publisher={Blackwell Synergy} }

@article{haiskendenew2005ddc, title={{DTC--Desktop Companion to the German SocioEconomic Panel Study (SOEP), DIW, Berlin}}, author={Haisken-DeNew, JP and Frick, JR}, journal={Online: http://www. diw. de/english/sop/service/dtc/(accessed 10th Jan. 2006)}, year={2005} }

@article{herles2004gk, title={{Die gesetzliche Krankenversicherung}}, author={Herles, D.}, journal={Online: http://www. gesundheitspolitik. net/ 01\_gesundheitssystem/ krankenversicherung/ gkv/ KBVfobi02-GKV\_2004.pdf}, year={2004} }