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PER-PERIOD CO-PAYMENTS AND THE DEMAND FOR HEALTH CARE: EVIDENCE FROM SURVEY AND CLAIMS DATA

Authors

  • Helmut Farbmacher,

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    • Max Planck Society, Munich Center for the Economics of Aging, Munich, Germany
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  • Joachim Winter

    1. Max Planck Society, Munich Center for the Economics of Aging, Munich, Germany
    2. Center for Economic Studies and Institute for Economic Research (CESifo), Munich, Germany
    3. Department of Economics, University of Munich, Munich, Germany
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Correspondence to: Munich Center for the Economics of Aging, Amalienstr. 33, 80799 Munich, Germany. Email: farbmacher@mea.mpisoc.mpg.de

ABSTRACT

When health insurance reforms involve non-linear price schedules tied to payment periods (for example, fees levied by quarter or year), the empirical analysis of its effects has to take the within-period time structure of incentives into account. The analysis is further complicated when demand data are obtained from a survey in which the reporting period does not coincide with the payment period. We illustrate these issues using as an example a health care reform in Germany that imposed a per-quarter fee of €10 for doctor visits and additionally set an out-of-pocket maximum. This co-payment structure results in an effective ‘spot’ price for a doctor visit that decreases over time within each payment period. Taking this variation into account, we find a substantial reform effect—especially so for young adults. Overall, the number of doctor visits decreased by around 9% in the young population. The probability of visiting a physician in any given quarter decreased by around 4 to 8 percentage points. Copyright © 2013 John Wiley & Sons, Ltd.

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