Objectives Value-based insurance design (VBID) aims to direct consumers' preferences by incentivizing the use of high-value care and discouraging the use of low-value care. However, consumers often have limited knowledge of health insurance and the health insurance system, possibly distorting...

The Extended Medicare Safety Net (EMSN) in Australia was designed to provide financial assistance to patients with high out-of-pocket (OOP) costs for medical treatment. The EMSN works on a calendar year basis. Once a patient incurs a specified amount of OOP costs, the EMSN provides additional...

Foreigners from third countries are not entitled to participate in the Czech public health insurance system unless they have either permanent residence in the Czech Republic or a Czech employer. This article aims to analyse the economic impact of the possible inclusion of such foreigners into...

Background We investigate access disparities in pharmaceutical care among German patients with type 2 diabetes, focusing on differences between public and private health insurance schemes. The primary objectives include investigating whether patients with private health insurance experience...

In Österreich wurden insgesamt 53,6 Mrd. € für Gesundheit ausgegeben (2022). Mit etwa 12,5 Mrd. € finanzierte der private Sektor knapp ein Viertel der Gesamtausgaben, davon gaben die Privathaushalte 8 Mrd. € direkt (out-of-pocket) für Gesundheit aus. Die private Krankenversicherung kam...

In theory, guaranteed renewable (GR) insurance contracts can efficiently protect individuals against reclassification risk without the negative side effects of price regulation, such as adverse selection. For these contracts to work properly, consumers must pay front-loaded premiums when healthy...

The Australian government pays $6.5 billion per year in rebates to encourage Australians to purchase private health insurance (PHI) and an additional $3 billion to cover private inpatient medical services. What is the justification for large government subsidies to a private industry when all...

In countries with dual public and private healthcare systems, individuals are often incentivised to purchase private health insurance through subsidies and penalty. We use administrative data from Australia to study how high-income earners respond on both the intensive and extensive margins to...

Background Lower-middle-income countries (LMICs) have a common goal to achieve universal health coverage (UHC) through voluntary health insurance schemes. This is important to improve access to healthcare services and ensure fnancial protection for all by reducing out-of-pocket expenditures....

The present paper outlines measures of disparity in healthcare access and health outcomes, drawing from the standardized metrics introduced in one related study (Bancalari et al., 2023). Beveridge countries seem to be less unequal than Bismarckian countries. Yet, there is no strong pattern in...

How do patient and provider incentives affect the provision of long-term care? Our analysis of 551 thousand nursing home stays yields three main insights. First, Medicaid-covered residents prolong their stays instead of transitioning to community-based care due to limited cost-sharing. Second,...

In countries with dual public and private healthcare systems, individuals are often incentivised to purchase private health insurance through subsidies and penalty. We use administrative data from Australia to study how high-income earners respond on both the intensive and extensive margins to...

A feature of many insurance markets is that they combine vertical differentiation (all consumers prefer high to low-coverage policies) and adverse selection (high cost customers prefer high-coverage plans). Building on Novshek and Sonnenschein (1978) and Azevedo and Gottlieb (2017), this paper...

Premiums and eligibility for health insurance may cause a "marriage lock," in which couples stay married for the sake of maintaining health insurance coverage. By using the Health and Retirement Study for adults aged 60-70, I examine whether employer-based health insurance coverage for the...

How do patient and provider incentives affect the provision of long-term care? Our analysis of 551 thousand nursing home stays yields three main insights. First, Medicaid-covered residents prolong their stays instead of transitioning to community-based care due to limited cost-sharing. Second,...

To limit price variations across consumers, the ACA requires that an insurance plan sold on the Health Insurance Marketplaces be uniformly priced across multiple counties within a geographic rating area. However, insurers’ service areas are not regulated by the ACA which could result in...

In theory, guaranteed renewable (GR) insurance contracts can efficiently protect individuals against reclassification risk without the negative side effects of price regulation, such as adverse selection. For these contracts to work properly, consumers must pay front-loaded premiums when healthy...

Tarifdifferenzierung in der privaten Krankenversicherung anhand von gesundheitsbezogenen Verhaltensdaten des Versicherungsnehmers, wie sie sich im Zeitpunkt des Vertragsschlusses darstellen - wie etwa der Impfstatus gegen Covid-19 -, ist grundsätzlich zulässig. Anderes gilt für eine...

The market of private health insurance is characterised by high level of consumer inertia. Low consumer activity is probably linked to product complexity, abundance of choice options and low consumer understanding. These factors may overwhelm consumers and reduce willingness to engage with the...

We study the link between illness severity and the use of public health care services by the privately insured under a public health system. Our theoretical model shows that this relationship will depend on the prioritization established by the public health authorities, the cost of waiting and...

The ACA provided funding to help states expand Medicaid eligibility. Expansions in Medicaid eligibility, however, could "crowd out" private insurance coverage. To estimate the extent of such crowd out, I use a difference-in-difference empirical approach, examining changes in health insurance...

This paper investigates the optimal private health insurance contract design problem considering the joint interests of a policyholder and an insurer. They jointly determine the premium of a private health insurance. To better reflect the reality, the illness expenditure is governed by an...

Background: The role of private health insurance in protecting the population's health is an essential global concern. However, the for-profit nature of private health insurance has led to inequality of opportunity for coverage, which has implications for the health performance of...

Penalty mandates are used in many countries to encourage people to purchase health insurance. But are they effective? We use a large administrative dataset for a 10% random sample of all Australian tax-filers to study how people respond to a step-wise age-based mandate, and whether this has...

Can the expansion of Medicaid, a means-tested health and long-term care insurance, be slowed down by incentivising the purchase of private long-term care insurance (LTCI)? We study the implementation of the long-term care insurance partnership (LTCIP) program, a joint federal and state-level...