Moral hazard and the demand for health services: a matching estimator approach

Journal of Health Economics
Pedro Pita BarrosAnna Sanz-de-Galdeano

Abstract

We estimate the impact of extra health insurance coverage beyond a National Health System on the demand for several health services. Traditionally, the literature has tried to deal with the endogeneity of the private (extra) insurance decision by finding instrumental variables. Since a priori instrumental variables are hard to find we take a different approach. We focus on the most common health insurance plan in Portugal, ADSE, which is given to all civil servants and their dependents. We argue that this insurance is exogenous, i.e., not correlated with the beneficiaries' health status. This identifying assumption allows us to estimate the impact of having ADSE coverage on the demand for three different health services using a matching estimator technique. The health services used are number of visits, number of blood and urine tests, and the probability of visiting a dentist. Results show large positive effects of ADSE coverage for number of visits and tests among the young (18-30 years old) but only the latter is statistically significantly different from zero. The effects represent 21.8% and 30% of the average number of visits and tests for the young. On the contrary, we find no evidence of moral hazard on the probability o...Continue Reading

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Citations

Feb 9, 2012·Health Economics·Omar PaccagnellaGuglielmo Weber
May 9, 2014·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Richard Layte, Anne Nolan
Jun 15, 2016·Journal of Health Organization and Management·Roger Lee Mendoza
Nov 15, 2017·BMC Health Services Research·David Cantarero-PrietoNoelia Gonzalez-Prieto
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Jan 1, 2016·Risk Analysis : an Official Publication of the Society for Risk Analysis·J Bradley KarlPatrick F Maroney
Jun 1, 2015·International Journal of Health Economics and Management·Izabela Jelovac
Mar 1, 2015·International Journal of Health Economics and Management·Richard Layte, Anne Nolan
May 10, 2017·International Journal of Health Economics and Management·Astrid Kiil, Jacob Nielsen Arendt
Nov 28, 2020·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Aida Isabel Tavares, Inês Marques

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