Demand For Private Health Insurance Research Articles

Financial incentives and private health insurance demand on the extensive and intensive margins

In countries with dual public and private healthcare systems, individuals are often incentivized 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 the simultaneous withdrawal of a premium subsidy, and the increase of a tax penalty. We estimate regression discontinuity models by exploiting discontinuous changes in the penalty and subsidy rates. Our setting is particularly interesting because means testing creates different incentives at the extensive and intensive margins. Specifically, we could expect to see higher take-up of insurance coupled with downgrading to less expensive plans. We find evidence that the penalty – despite being large in value – only has a modest effect on take-up. Our results show little evidence of downgrading, which is consistent with a low price elasticity for the high-income earners we study.

Factors Analysis Influencing on Demand for Private Health Insurance in Indonesia After Pandemic

The study focused on the purpose of this writing is to find out the importance of today's health insurance such as protection for yourself and your family, by having health insurance you and your family will get health protection. If at any time you need treatment and medication, insurance will cover these needs. Sickness is an unexpected event that can happen to anyone, including yourself and your family. Therefore, with the protection you get from insurance, you will be calmer in living your life and not confused if you must spend large funds for medical needs. This study uses qualitative research methods, which are related to the subject and research informants. Private health insurance in Indonesia still has an important role to play in protecting individuals and families from the financial risks associated with health care costs. The demand for private health insurance is influenced by several complex and varied factors. An analysis of the factors affecting the demand for private health insurance in Indonesia will be important after the pandemic is over. Through a better understanding of these factors, the government and the private sector can make policy decisions in designing appropriate strategies to improve the accessibility, sustainability, and quality, of private health insurance.

Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia.

Malaysia's subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.

Financial Incentives and Private Health Insurance Demand on the Extensive and Intensive Margins

Financial Incentives and Private Health Insurance Demand on the Extensive and Intensive Margins

Financial incentives and private health insurance demand on the extensive and intensive margins

Financial incentives and private health insurance demand on the extensive and intensive margins

TÜRKİYE’DE ÖZEL SAĞLIK SİGORTASI TALEBİNİN İKİLİ LOJİSTİK REGRESYON YÖNTEMİYLE ANALİZİ

Bireylerin hayatlarında karşılarına çıkabilecek olumsuzluklar karşısında önlem alarak kendilerini güvende hissetme ihtiyacı bulunmaktadır. İnsanların daha sağlıklı bir yaşam sürme gayesi beraberinde özel sağlık sigortalarına olan ilgiyi de artırmıştır. Özel sağlık sigortalarının gelişimi bireylerin yaşamlarına pozitif katkılar sağlamaktadır. Aynı zamanda devletin de hem yükünü hafifletmekte hem de istihdamın gelişimine olumlu katkılar sunmaktadır. Bu yönleriyle değerlendirildiğinde bireylerin özel sağlık sigortası talebini etkileyen faktörlerin araştırılması önemlidir. Bu çalışmada, Türkiye’de özel sağlık sigortası talebini etkileyen faktörleri belirlemek amaçlanmaktadır. Bu amaç doğrultusunda örneklem olarak 2019 Türkiye İstatistik Kurumu Hanehalkı Bütçe Anketi veri seti kullanılmıştır. Çalışmanın ekonometrik analizinde, ikili lojistik regresyon yöntemi uygulanmıştır. Çalışmada elde edilen bulgulara göre, özel sağlık sigortası sahipliğini etkileyen değişkenler arasında cinsiyet, yaş, medeni durum, eğitim ve aylık gelir değişkenleri ile birçok meslek gruplarına ait parametrelerde anlamlı sonuçlar elde edilmiştir.

Population Aging and the Demand for Private Health Insurance in China

Abstract This study examines the potential impact of aging on the demand for private health insurance (PHI) in China. Using the provincial data for 2000–2018, we find that a 1-percent increase in each proportion of the elderly population and old-age dependency ratio increases the PHI demand by 4.8 and 5.2%, respectively. A one-percent increase in the child dependency ratio decreases the PHI demand by 1.5%. We employ an instrumental variable approach; the findings support that the proportion of the elderly individuals in the total population, old-age dependency ratio, child dependency ratio, and urban green area significantly affect the PHI demand. The rolling estimate indicates that aging has a significant positive effect on the PHI demand over a rolling window of a fixed sample size. Additionally, by controlling for province and year fixed effects, we find that aging is positively associated with the PHI demand in China.

Impact of the Guaranteed Health Plan with a single community premium on the demand for private health insurance in Chile

In 2012, a Guaranteed Health Plan for the private health system was submitted to the Chilean National Congress, with the aim of offering a standardized flat-rate health-care plan. This paper evaluates the impact that the introduction of this plan would have on the demand for health insurance. The results suggest that the private insurance portfolio would shrink by 12.39%, which means that around 400,000 people would switch to the public system, thereby exacerbating the adverse-selection problem faced by the system and imposing an additional fiscal burden of US$ 200 million per year.

The effects of the economic recession on spending on private health insurance in Spain

The paper seeks to analyse the evolution of expenditure on private health insurance (PHI) in Spain. We consider the factors that influence PHI demand and level of spending before and during the economic recession, along with identifying the effect of the recession on these factors. The data is obtained from the Spanish Family Budget Survey (SFBS) for 2006 and 2012. Due to the data structure and the demand function, the analysis is performed using a sample selection model in order to avoid sample selection bias. We estimate three models: a pre-recession model (2006), a model for the recession period (2012) and a third one covering both periods (2006 and 2012) and where we include a dummy variable that establishes the effect of the economic recession. The results show that the effect of the economic recession on PHI demand is not significant, but it is on the level of spending.

Nonparametric kernel estimation of the impact of tax policy on the demand for private health insurance in Australia

SummaryThis paper is motivated by our attempt to answer a policy question: how is private health insurance take‐up in Australia affected by the income threshold at which the Medicare Levy Surcharge (MLS) kicks in? We propose a new difference deconvolution kernel estimator for the location and size of regression discontinuities. We also propose a bootstrapping procedure for estimating the confidence interval for the estimated discontinuity. Performance of the estimator is evaluated by Monte Carlo simulations before it is applied to estimating the effect of the income threshold of MLS on the take‐up of private health insurance in Australia, using contaminated data.

Social insurance, private health insurance and individual welfare

This paper studies the impact of social insurance on individual choices and welfare in a dynamic general equilibrium model with uncertain medical expenses and individual health insurance choices. I find that social insurance (modeled as the combination of a minimum consumption floor and the Medicaid program) does not only distort saving and labor supply decisions, but also has a large crowding out effect on the demand for private health insurance. However, despite the distorting effects, the net welfare consequence of eliminating social insurance is still negative in most cases. In addition, the large crowding out effect on private health insurance suggests that the existence of social insurance programs may be one reason why some Americans do not buy any health insurance.

Premium subsidies and demand for private health insurance: results from a regression discontinuity design

ABSTRACTThis article investigates the impact of a private health insurance (PHI) subsidy on the demand for PHI in the context of the Australian health care system. In particular, we focus on the subpopulation of elderly Australians and exploit discontinuous increases to the universal ‘PHI rebate’ that occur when people turn 65 and 70 years. Using a regression discontinuity design, we find the policy has little effect on take-up of PHI and is best interpreted as a wealth transfer to elderly Australians who already have insurance.

Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia

Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia

Public–private sector interactions and the demand for supplementary health insurance in the United Kingdom

We examine the demand for private health insurance (PHI) in the United Kingdom and relate this to changes in the supply of public and private healthcare. Using a novel collection of administrative, private sector and survey data, we re-assess the relationships between the quality and availability of public and private sector inpatient care, and the demand for PHI. We find that PHI coverage in the United Kingdom is positively related to the median of the region- and year-specific public sector waiting times. We find that PHI prevalence ceteris paribus increases with being self-employed and employed, while it decreases with having financial difficulties. In addition, we highlight the complexities of inter-sectoral relations and their impact on PHI demand. Within a region, we find that an increase in private healthcare supply is associated with a decrease in public sector waiting times, implying lower PHI demand. This may be explained by the usage of private facilities by NHS commissioners. These results have important implications for policymakers interested in the role of private healthcare supply in enhancing the availability of and equitable access to acute inpatient care.

Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia

This paper is motivated by our attempt to answer an empirical question: how is private health insurance take-up in Australia affected by the income threshold at which the Medicare Levy Surcharge (MLS) kicks in? We propose a new difference de-convolution kernel estimator for the location and size of regression discontinuities. We also propose a bootstrapping procedure for estimating confidence bands for the estimated discontinuity. Performance of the estimator is evaluated by Monte Carlo simulations before it is applied to estimating the effect of the income threshold of Medicare Levy Surcharge on the take-up of private health insurance in Australia using contaminated data.

Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia

Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia

Tax incentives and the demand for private health insurance

We analyze the effect of an individual insurance mandate (Medicare Levy Surcharge) on the demand for private health insurance (PHI) in Australia. With administrative income tax return data, we show that the mandate has several distinct effects on taxpayers’ behavior. First, despite the large tax penalty for not having PHI coverage relative to the cost of the cheapest eligible insurance policy, compliance with mandate is relatively low: the proportion of the population with PHI coverage increases by 6.5 percentage points (15.6%) at the income threshold where the tax penalty starts to apply. This effect is most pronounced for young taxpayers, while the middle aged seem to be least responsive to this specific tax incentive. Second, the discontinuous increase in the average tax rate at the income threshold created by the policy generates a strong incentive for tax avoidance which manifests itself through bunching in the taxable income distribution below the threshold. Finally, after imposing some plausible assumptions, we extrapolate the effect of the policy to other income levels and show that this policy has not had a significant impact on the overall demand for private health insurance in Australia.

Factors affecting demand for individual health insurance in Malaysia

Background Private health insurance is one of the sources of funds for financing health care apart from direct taxes, public insurance and out of pocket payments. Regardless of the choice between a social and private insurance, health insurance ownership has been linked with lower OOP. Thus, health insurance as a type of health care financing, no doubt, will be one of the financing mechanisms in the health care financing model. As such, understanding the individual decision making towards health insurance is imperative. This paper analyses the factors that affect the individual demand for private health insurance in Malaysia.

Private Health Insurance Incentives in Australia: The Effects of Recent Changes to Price Carrots and Income Sticks

Three major policy tools govern the demand for private health insurance (PHI) in Australia: premium-related subsidies (i.e. PHI-rebate); income tax surcharges (i.e. the Medicare Levy Surcharge (MLS)); and lifetime community-rating (i.e. Lifetime Health Cover). The first two provide a system of carrots and sticks to create incentives for increasing the demand for PHI. The third creates incentives for consumers to purchase PHI earlier than they otherwise would have, and to maintain this coverage over time even when prices rise. This paper makes a number of contributions to the existing literature. We develop a diagrammatic model that incorporates income heterogeneity and use it to consider two important policy issues: the effect of policy changes on consumer price responsiveness, and the effect of policy changes on the PHI take-up rates. The model suggests that recent changes to the income tax surcharge are likely to reduce the price elasticity of demand for insurance, which could have further consequences for outcomes in the PHI market and the health system more generally. Increases in premiums will reduce take-up, but could worsen the government's budget position, even if tax revenues were to rise. Finally, we conduct numerical simulations to examine the possible effects of recent policy changes, which are aimed at further means-testing the PHI rebate and the MLS. The simulation results suggest that these recently adopted policy changes are likely to reduce the take-up of PHI as well as consumers' responsiveness to future premium increases.

National Health Insurance Reform in South Africa

A recent health reform proposal in South Africa proposes universal access to a comprehensive package of healthcare services in the public sector, through the implementation of a national health insurance (NHI) scheme. Implementation of the scheme is likely to involve the introduction of a payroll tax. It is implied that the introduction of the payroll tax will significantly reduce the size of the private health insurance market. The objective of this study was to estimate the impact of an NHI payroll tax on the demand for private health insurance in South Africa, and to explore the broader implications for health policy. The study applies probit regression analysis on household survey data to estimate the change in demand for private health insurance as a result of income shocks arising from the proposed NHI. The introduction of payroll taxes for the proposed NHI was estimated to result in a reduction to private health insurance membership of 0.73%. This suggests inelasticity in the demand for private health insurance. In the literature on the subject, this inelasticity is usually due to quality differences between alternatives. In the South African context, there may be other factors at play. An NHI tax may have a very small impact on the demand for private health insurance. Although additional financial resources will be raised through a payroll tax under the proposed NHI reform, systemic problems within the South African health system can adversely affect the ability of the NHI to translate additional finances into better quality healthcare. If these systemic challenges are not adequately addressed, the introduction of a payroll tax could introduce inefficiencies within the South African health system.