Supplemental health insurance and equality of access in Belgium.
The effects of supplemental health insurance on health-care consumption crucially depend on specific institutional features of the health-care system. We analyse the situation in Belgium, a country with a very broad coverage in compulsory social health insurance and where supplemental insurance mainly refers to extra-billing in hospitals. Within this institutional background, we find only weak evidence of adverse selection in the coverage of supplemental health insurance. We find much stronger effects of socio-economic background. We estimate a bivariate probit model and cannot reject the assumption of exogeneity of insurance availability for the explanation of health-care use. A count model for hospital care shows that supplemental insurance has no significant effect on the number of spells, but a negative effect on the number of nights per spell. We comment on the implications of our findings for equality of access to health care in Belgium.
Schokkaert
Erik
E
Department of Economics, KULeuven, Naamsestraat 69, Leuven, Belgium. erik.schokkaert@econ.kuleuven.be
Van Ourti
Tom
T
De Graeve
Diana
D
Lecluyse
Ann
A
Van de Voorde
Carine
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001530:Belgium; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D019458:Insurance Coverage / Q000458:organization & administration*; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D017149:Private Sector; D013222:State Medicine; D055815:Young Adult