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Does Free Supplementary Health Insurance Help the Poor to Access Health Care? [electronic Resource] : Evidence from France

Michel GrignonJohn LavisMarc PerronninMcMaster University. Centre for Health Economics and Policy Analysis

出版	Centre for Health Economics and Policy Analysis, McMaster University, 2006
URL	http://books.google.com.hk/books?id=jRy8DAEACAAJ&hl=&source=gbs_api

註釋To assess the impact of the introduction of the plan on its beneficiaries, we use a longitudinal dataset to compare, for the same individual, the evolution of his/her expenditures before and after enrolment in the plan. [...] A survey conducted in 1998 (i.e., before the introduction of the free plan) found that only 52% among the individuals in the lowest income bracket (i.e., the poorest 5% of the population) reported that they were covered through a commercial plan, compared to 85% of the entire population [22]. [...] The very poor accounted for about 3% of the population at the time of the introduction of the free plan. [...] The third type of transition was the most dramatic: those who were not enrolled in either a commercial plan or the means-tested plan and who enrolled in the free plan moved from facing all forms of out-of-pocket payments at the point of use and being only partially reimbursed later from the social sickness fund to facing no out-of-pocket payments at the point of use. [...] We can infer, however, that the enrollment bias leads to overestimating the impact of the new free plan on health utilization: Because the decision to enrol is likely to be positively correlated to planned utilization of health care, we can expect that, even using the fixed effect, we overestimate the impact of enrollment in the plan on those with no previous coverage.