Abstract

In this paper we study the relationship between access to healthcare and different types of self-employment (distinguishing between solo self-employed and entrepreneurs, that is self-employed with employees), focusing on the main reasons and conditions behind unmet healthcare needs. The empirical analysis is based on individual data for 17 European countries from the European Social Survey (ESS) complemented with country-level indicators of health systems. We find that, conditional on a rich set of observable characteristics, it is just the solo self-employed that are significantly more likely than employees to report unmet medical needs. Barriers related to affordability are relevant especially for solo self-employed, while acceptability-related reasons matter for all the employment groups considered, albeit with different nuances. Multilevel estimates complement these results by highlighting the relevance of the interaction between individual types of self-employment status and country-level characteristics of the health systems in influencing perceived barriers in healthcare access.

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