title: Waiting times for elective surgery and the decision to buy private health insurance.
abstract: More than 45% of Australians buy health insurance for private treatment in hospital. This is despite having access to universal and free public hospital treatment. Anecdotal evidence suggests that avoidance of long waits for public treatment is one possible explanation for the high rate of insurance coverage. In this study, we investigate the effect of waiting on individual decisions to buy private health insurance. Individuals are assumed to form an expectation of their own waiting time as a function of their demographics and health status. We model waiting times using administrative data on the population hospitalised for elective procedures in public hospitals and use the parameter estimates to impute the expected waiting time and the probability of a long wait for a representative sample of the population. We find that expected waiting time does not increase the probability of buying insurance but a high probability of experiencing a long wait does. On average, waiting time has no significant impact on insurance. In addition, we find that favourable selection into private insurance, measured by self-assessed health, is no longer significant once waiting time variables are included. This result suggests that a source of favourable selection may be aversion to waiting among healthier people.
authors.affiliation: University of Technology, Sydney, NSW, Australia.
authors.forename: Meliyanni
authors.initials: M
authors.lastname: Johar
authors.forename: Glenn
authors.initials: G
authors.lastname: Jones
authors.forename: Michael
authors.initials: M
authors.lastname: Keane
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Savage
authors.forename: Olena
authors.initials: O
authors.lastname: Stavrunova
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003657:Decision Making; D017558:Elective Surgical Procedures; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D017149:Private Sector / Q000191:economics / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D014850:Waiting Lists