Regardless that the brand new Federal Law on Socal Medical health insurance (LAMal) was mplemented n 1996 to advertise competton among well being nsurers, there stll remans massive premum varatons wthn cantons. Ths ndcates that competton has not been ready to this point to result in a sngle prce, and letts.org reveals some nerta amongst shoppers who seem reluctant to swtch to much less expensve funds. We nvestgate one possble barrer to swtchng behavour, particularly the nfluence of the supplementary nsurance on the choce for basc nsurance plan n Swtzerland, whch has not been studed to date. Our am s to analyse the 2 decsons (choce of health plan, subscrpton to supplementary nsurance contracts). We use the information of the OFAS survey conducted n 2000 on well being plan choce and mport some addtonal knowledge on the sckness funds (variety of enrollees, premums). The decson to swtch s estmated by each logt and a fxed-effects logt fashions; two man explanatory varables are studed: premums (for furniture basc nsurance contracts) and supplementary nsurance. This has been gener ated by GSA Content G enerat or Demoversion!
The results recommend that holdng a supplementary nsurance contract substantally decreases the propensty to swtch. The swtchng decson s postvely nfluenced by the expected gan of swtchng, measured by the premum dfferental. The anticipated gan of swtchng s hgher for swtchers wth no supplementary nsurance (CHF 19.44) than for swtchers wth supplementary nsurance (CHF 13.06). The ncome degree has a drect postve nfluence on the propensty to buy a supplementary nsurance. Ths fndng means that the purchase of supplementary nsurance s nfluenced, Sales not solely by rsk averson, but additionally by the wllngness to pay for the goods coated by the supplementary nsurance, whch can be hgher for rch folks. Dangerous health has a negatve nfluence on the subscrpton to a supplementary contract, but s no longer sgnfcant when the ncome s ntroduced nto the specfcaton. All the nformaton about well being s captured by the ncome level, a low ncome beng strongly correlated wth a nasty health status. This data was created with the help of G SA Con te nt Ge nerator DE MO.
Earnings and a supplementary nsurance contract are observable by the nsurance company, and can be used as instruments for selecton. 5 1. Introducton Accordng to ts advocates, competton n health nsurance markets should promote effcency n nsurance and care delvery. However, t may have some potental drawbacks, lnked to the ncentves t provdes for rsk selecton. Managed competton settngs have been mplemented to deal wth these dffcultes: homogenous contracts are defned to avod competton on protection, well being funds are usually not allowed to show down an enrolee and a rsk-adjustment scheme s ntroduced to elmnate ncentves for rsk selecton. However, the effectveness of competton between sckness funds s a prerequste earlier than any evaluation about ts postve or potental dangerous results. Charactersng client behavour n health nsurance choce s a crucal ssue to examne whether competton s effectve. Ths paper focuses on the swtchng behavour of sckness funds enrolees n the Swss well being nsurance system. Truly, Swtzerland s a wonderful case for studyng competton n well being nsurance markets: n 1996, the Federal Regulation on Socal Medical insurance (LAMal) was adopted, whch amed at ntroducng an ideal managed competton scheme.
In Swtzerland versus all different countres, Amazon Fashion health nsurance can't be provded by the employer as a frnge beneft: the premum s absolutely pad by the enrolee, whch ought to make her more reactve to dfferences n premums. The reform ntroduced by the LAMal was desgned n lne wth the managed competton scheme. The basc well being nsurance was defned as a homogenous product,.e. In idea, Amazon Fashion Beauty premum dfferences for the basc bundle ought to then dsappear. Nevertheless, emprcal results on Swss knowledge do not assist ths predcton (Beck et al., 2003 ; Colombo, 2002): snce 1996, the premum varablty has been qute massive and has decreased only slghtly. Ths dsappontng consequence suggests a number of nterpretatons. It could reveal: () dfferences n servce qualty, () nerta of shoppers resultng from swtchng costs, () rsk selecton practces by the nsurers, (v) cross subsdes between basc and supplementary nsurance. We focus on the fourth nterpretaton (v). Despte the truth that t s forbdden to promote basc and supplementary nsurance as a jont contract, supplers behavour relatve to the prcng of supplementary nsurance contracts may nduce some perverse effects on the basc nsurance market.
Our goal s to judge the nfluence of the supplementary nsurance on the choce for basc nsurance plan n Swtzerland. A survey carred out by the Federal Offce of Socal Insurance (OFAS) present that seventy five % of nsurees have subscrbed to at least one supplementary nsurance contract. These contracts are normally subscrbed wth the identical nsurer as for the basc contract. Ths paper studes the decsons to swtch and to subscrbe to a supplementary nsurance contract. It s structured as follows. Secton 2 provdes a lterature revew on well being plan choce. Some theoretcal analyss s provided n secton 3. Secton four descrbes the information. 6 client choces are provded n secton 5. The econometrc specfcaton and the outcomes are introduced n secton 6. Concludng remarks and a dscusson of mplcatons are ncluded n the fnal secton of the paper. 2. Well being nsurance choce: present state of data Outsde the US, many ndustralsed countres have a socal health nsurance the place ctzens cannot choose between dfferent payers for the basc protection.
