This study seeks to provide evidence for deciding whether or not a pharmaceutical innovation should be included in the benefit list of social health insurance. A discrete choice experiment (DCE) was conducted in Germany to measure preferences for modern insulin therapy. Of the 1,100 individuals...

This paper sheds light on some unexpected consequences of health insurance regulation that may pose a big challenge to insurers’ risk management. Because mandated uniform contributions to health insurance trigger risk selection efforts risk adjustment (RA) schemes become necessary. A good deal...

When premiums are community-rated, risk adjustment (RA) serves to mitigate competitive insurers’ incentive to select favorable risks. However, unless fully prospective, it also undermines their incentives for efficiency. By capping its volume, one may try to counteract this tendency, exposing...

This article assesses how the form of the utility function in discrete-choice experiments (DCEs) affects estimates of willingness-to-pay (WTP). The utility function is usually assumed to be linear in its attributes. Non-linearities, in the guise of interactions and higher-order terms, are...

Health insurance is potentially subject to risk selection, i.e. adverse selection on the part of consumers and cream skimming on the part of insurers. Adverse selection models predict that competitive health insurers can eschew high-risk individuals by o¤ering contracts with low deductibles or...

Elements of regulation inherent in most social health insurance systems are a uniform package of benefits and uniform cost sharing. Both elements risk to burden the population with a welfare loss if preferences differ. This suggests introducing more contracted choice; however, it is widely...

Regulation fostering Managed Care alternatives in health insurance is spreading. This work reports on an experiment designed to measure the amounts of compensation asked by the Swiss population (in terms of reduced premiums) for Managed-Care type restrictions in the provision of health care. It...

The German health care reform of 1997 provides a natural experiment for evaluating the price sensitivity of demand for physicians’ services. As part of the reform, copayments for prescription drugs were increased by up to 200 percent. However, certain groups of people were exempted from the...

The paper evaluates the German health care reform of 1997, using the individual number of doctor visits as outcome measure and data from the German Socio- Economic Panel for the years 1995-1999. A number of modified count data models allow to estimate the effect of the reform in different parts...

This paper reports on a re-evaluation of the German health care reform of 1997. A previous evaluation found a limited effect of a 4.4 percent reduction of the number of doctor visits in a sample of pharmacy customers. The re-evaluation based on a representative household survey, the German...