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Journal Article

Does Moving to a System with a More Generous Public Health Insurance Increase Medical Care Consumption?

Laurent Davezies and Léa Toulemon
Annals of Economics and Statistics
No. 119/120, SPECIAL ISSUE ON HEALTH AND LABOUR ECONOMICS (December 2015), pp. 179-205
Published by: GENES on behalf of ADRES
DOI: 10.15609/annaeconstat2009.119-120.179
Stable URL: http://www.jstor.org/stable/10.15609/annaeconstat2009.119-120.179
Page Count: 27
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Does Moving to a System with a More Generous Public Health Insurance Increase Medical Care Consumption?
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Abstract

Using a natural experiment, we evaluate the impact of reimbursement rates on health expenditures. For historical reasons, reimbursement rates of public health insurance are higher in the Alsace-Moselle region of France than in other French regions. For both the regional and national systems, affiliation is compulsory. Individuals moving between Alsace-Moselle and the rest of France undergo an exogenous change in reimbursement rates. We use a difference-in-difference method on a panel dataset of individuals. Our treatment group consists of individuals changing system, our control group consists of individuals who move between other French regions. We study the impact of reimbursement rates on a broad range of health care expenditures: for the visits to the dentist and the doctor, consumption of medicines, and absenteeism due to sickness. We find heterogeneous impacts of reimbursement rates on those items. Overall, higher public reimbursement rates do not lead to an increase in spending for medical care. JEL: I18, D12, C23, H51. / KEY WORDS: Public Health Insurance, Health Expenditures, Natural Experiment, Moral Hazard.

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