How Do Health, Care Services Consumption and Lifestyle Factors Affect the Choice of Health Insurance Plans in Switzerland?

Veronika Kalouguina,Joël Wagner

doi:10.3390/risks8020041

Abstract

In compulsory health insurance in Switzerland, policyholders can choose two main features, the level of deductible and the type of plan. Deductibles can be chosen among six levels, which range from CHF 300 to 2500. While the coverage and benefits are identical, insurers offer several plans where policyholders must first call a medical hotline, consult their family doctor, or visit a doctor from a defined network. The main benefit of higher deductibles and insurance plans with limitations is lower premiums. The insureds’ decisions to opt for a specific cover depend on observed and unobserved characteristics. The aim of this research is to understand the correlation between insurance plan choices and lifestyle through the state of health and medical care consumption in the setting of Swiss mandatory health insurance. To do so, we account for individual health and medical health care consumption as unobserved variables employing structural equation modeling. Our empirical analysis is based on data from the Swiss Health Survey wherein lifestyle factors like the body mass index, diet, physical activity, and commuting mode are available. From the 9301 recorded observations, we find a positive relationship between having a “healthy” lifestyle, a low consumption of doctors’ services, and choosing a high deductible, as well as an insurance plan with restrictions. Conversely, higher health care services’ usage triggers the choice of lower deductibles and standard insurance plans.

Highlights

Health insurers try to foster healthy lifestyles among their insureds by promoting exercise, supporting fitness center memberships, and more recently, the use of wearable connected devices.The data collected from the latter permit insurance companies to track the individual’s physical activity, diet, or sleep patterns for instance
Using data from the Swiss Health Survey, we successfully established the relationship between lifestyle-defining behavior and decisions in a compulsory health insurance environment
Employing a structural equation model with health and health care consumption characterized by latent variables, we gave proof for the following conjectures

Summary

Introduction

Health insurers try to foster healthy lifestyles among their insureds by promoting exercise, supporting fitness center memberships, and more recently, the use of wearable connected devices.The data collected from the latter permit insurance companies to track the individual’s physical activity, diet, or sleep patterns for instance. Why health insurers promote a healthy lifestyle is not unfounded. Insurance Plans and Deductibles in the Swiss Health System. We expose some basic features of the Swiss health insurance system that are relevant for the matter of this study. Basic health insurance in Switzerland is mandatory and regulated by Federal law, which sets up the reimbursement policies. Individuals can subscribe to private complementary health insurance. Complementary health policies cover the costs that go beyond the basic insurance scheme. We focus on the decisions on basic health insurance by individuals aged 18 years and older. These individuals face several choices for their insurance plan and deductible level

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