title: The effect of variable health insurance deductibles on the demand for physician visits.
abstract: In order to contain cost in the health care sector, the introduction of consumer incentives in health insurance has been suggested and realized in many countries. The Swiss health system reform of 1996 introduced a choice of deductible for health services in the mandatory basic health insurance. This paper estimates the effect of this choice on physician service utilization. A generalized method of moments (GMM) estimator is applied to take account of the endogeneity of the choice of the deductible in the estimation of the number of physician visits. This paper finds that most of the observed reduction in the number of physician visits among individuals who choose a higher deductible seems to be a result of self-selection of individuals into the respective insurance contracts, and not to induced changes in utilization behaviour.
authors.affiliation: Institute of Economics, University of Bern, Switzerland. martin.schellhorn@vwi.unibe.ch
authors.forename: M
authors.initials: M
authors.lastname: Schellhorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003363:Cost Control; D003669:Deductibles and Coinsurance / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D018166:Health Care Reform / Q000458:organization & administration; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009017:Morbidity; D009313:National Health Programs / Q000458:organization & administration*; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D012044:Regression Analysis; D013557:Switzerland / Q000453:epidemiology