Abstract
This paper analyses the effect of absolute deductibles on the cost of insurance for outpatient services. Moreover, cost savings on retained losses are estimated. Sharing risks between the insured and the insurer reduces total expenditure for outpatient benefits by up to 35%. In particular, optimal deductibles are determined in their utilitarian sense: the maximum possible savings on medical expenses are computed from the ground up. As part of the study, the effect of age and gender on these savings is analysed. The analysis is based on data taken from the private medical insurance industry in Germany. Similarities and discrepancies with respect to results obtained in the RAND Health Insurance Experiment conducted in the United States from 1971 to 1982 are highlighted.
Similar content being viewed by others
References
Bakker, F.M., van Vliet, R.C.J.A., van den Ven, W.P.M.M.: Deductibles in health insurance: can the actuarially fair premium reduction exceed the deductible? Health Policy 53(2), 123–141 (2000)
Buchmueller, T.C.: The health plan choices of retirees under managed competition. Health Serv. Res. 35(5), 949–976 (2000)
Bundesanstalt für Finanzdienstleistungsaufsicht (BaFin): Wahrscheinlichkeitstafeln in der privaten Krankenversicherung 2007, URL: http://www.bafin.de/cln_116/nn_722564/SharedDocs/Artikel/DE/Service/Statistiken/st__wahrschktafelnpkv2007__va.html (2007; on 9 January 2009)
Chiappori, P.-A., Durand, F., Geoffard, P.-Y.: Moral hazard and the demand for physician services: first lessons from a natural experiment. Eur. Econ. Rev. 42(3–5), 499–511 (1998)
Goodman, J.C.; Musgrave, G.L.: Patient power: solving america’s health care crisis. Cato Institute, Washington, DC (1992)
Felder, S., Werblow, A.: Der Einfluss von freiwilligen Selbstbehalten in der gesetzlichen Krankenversicherung. Schmollers Jahrb. 123(2), 235–264 (2003)
Holly, A.L., Gardiol, G., Domenighetti, G., Bisig, B.: An econometric model of health care utilization and health insurance in Switzerland. Eur. Econ. Rev. 42(3–5), 513–522 (1998)
Keeler E.B., et al.: The demand for episodes of treatment in the heath insurance experiment. The RAND Corporation, Report R-3454-HHS, Santa Monica, CA (1988)
Lohr, K.N., Brook, R.H., Kamberg, C.J., Goldberg, G.A., Liebowitz, A., Keesey, J.: Use of medical care in the Rand Health Insurance Experiment. Diagnosis- and service-specific analyses in a randomized controlled trial. Med. Care 24, 1–87 (1986)
Manning, W., Newhouse, J., Duan, N., et al.: Health insurance and the demand for medical care: evidence from a randomized experiment. Am. Econ. Rev. 77(3), 251–277 (1987)
Newhouse, J., The Insurance Experiment Group: Free for all? Lessons from the RAND Health Insurance Experiment, 2 edn. Harvard University Press, Cambridge (1996)
Pütz, C.: Selbstbehalttarife für die Gesetzliche Krankenversicherung. Nomos, Baden-Baden (2003)
Schellhorn, M.: The effect of variable health insurance deductibles on the demand for physician visits. Heath Econ. 10, 441–456 (2001)
Schellhorn, M.: Auswirkungen wählbarer Selbstbehalte in der Krankenversicherung: Lehren aus der Schweiz. Vierteljahrshefte zur Wirtschaftsforschung 71(4), 411–426 (2002)
Schreyoegg, J.: Medical savings accounts. Baden-Baden (2003)
Schut, F.T., Hassink, W.H.J.: Managed competition and consumer price sensitivity in social health insurance. J. Health Econ. 802, 1–21 (2002)
Schut, F.T., Greß, S., Wasem, J.: Consumer price sensitivity and social health insurer choice in Germany and the Netherlands. Int. J. Health Care Finan. Econ. 3, 117–138 (2003)
Strombom, B.A., Buchmueller, T.C., Feldstein, P.J.: Switching costs, price sensitivity and health plan choice. J. Health Econ. 21, 89–116 (2002)
van Dijk, M., et al.: Consumer price sensitivity in Dutch health insurance. Int. J. Health Care Finan. Econ. 4, 225–312 (2008)
van Vliet, R.C.J.A.: Deductibles and health care expenditures: empirical estimates of price sensitivity based on administrative data. Int. J. Health Care Finance Econ. 4, 283–305 (2004)
Werblow, A.: Alles nur Selektion? Der Einfluss von Selbstbehalten in der gesetzlichen Krankenversicherung. Vierteljahrshefte Wirtschaftsforsch. 71(4), 411–426 (2002)
Ziegenbein, R.: Mit dem Gesundheits-Sparkonto zu mehr Eigenverantwortung: Ein Ansatz zur Reform eines solidaren Gesundheitssystems. In: Reinermann, H. (ed.), Das Dilemma der modernen Medizin, Nomos, Baden-Baden, pp. 169–203 (2006)
Zweifel, P., Manning, W.G.: Moral hazard and consumer incentives in health care. In: Culyer, A.J., Newhouse, J.P. (eds.) Handbook of health economics, pp. 409–460. Amsterdam, Elsevier (2000)
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ortmann, KM. Optimal deductibles for outpatient services. Eur J Health Econ 12, 39–47 (2011). https://doi.org/10.1007/s10198-010-0222-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10198-010-0222-x