Supplemental health insurance in the Colombian managed care system: Adverse or advantageous selection?
Autor: | Giancarlo Buitrago, David Bardey |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male Moral hazard Adverse selection Public expenditure Mandatory Programs Colombia Insurance Selection Bias Insurance Coverage 03 medical and health sciences 0502 economics and business Auto insurance risk selection Humans 050207 economics Selection (genetic algorithm) Consumption (economics) Insurance Health Actuarial science Public economics 030503 health policy & services Health Policy Managed Care Programs 05 social sciences Public Health Environmental and Occupational Health Group insurance Middle Aged Managed care Female Business 0305 other medical science Algorithms |
Zdroj: | Journal of Health Economics. 56:317-329 |
ISSN: | 0167-6296 |
Popis: | The aim of this article is to estimate the type of selection that exists in the supplemental health insurance market in Colombia where compulsory coverage is implemented through managed care competition. We build a panel database that combines individuals' information from the Ministry of Health and a database provided by two private health insurers. We perform the correlation test for consumption of health services frequency and supplemental coverage. Following Fang et al. (2008), we condition the estimation on health controls that are available to the econometrician but not to insurers. In both cases we obtain a positive correlation, suggesting that adverse selection predominates. In order to rule out some moral hazard effects, we estimate the correlation between previous frequency of healthcare service consumption and supplemental insurance purchase. The positive correlation obtained is robust to the inclusion of controls for diagnosis implemented by health insurers, suggesting that despite some risk selection strategies, they are not protected from adverse selection. We conclude that some subsidies to supplemental coverage purchase would lower public expenditure in Colombia. |
Databáze: | OpenAIRE |
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