title: Public-private sector interactions and the demand for supplementary health insurance in the United Kingdom.
abstract: 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.
authors.affiliation: School of Economics, University of Edinburgh, United Kingdom; Department of Health Economics, Corvinus University of Budapest, Hungary.
authors.forename: Anikó
authors.initials: A
authors.lastname: Bíró
authors.affiliation: Global Public Health Unit, University of Edinburgh, United Kingdom. Electronic address: mark.hellowell@ed.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Hellowell
mesh_terms: D006301:Health Services Needs and Demand; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D009313:National Health Programs; D017149:Private Sector / Q000191:economics*; D017150:Public Sector / Q000191:economics*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014850:Waiting Lists
keywords: Demand; Hospitals; National Health Service; Private health insurance; Quality; Waiting times