Supplemental health insurance and equality of access in Belgium

The effects of supplemental health insurance on health‐care consumption crucially depend on specific institutional features of the health‐care system. We analyse the situation in Belgium, a country with a very broad coverage in compulsory social health insurance and where supplemental insurance main...

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Bibliographic Details
Published in:Health economics 2010-04, Vol.19 (4), p.377-395
Main Authors: Schokkaert, Erik, Van Ourti, Tom, De Graeve, Diana, Lecluyse, Ann, Van de Voorde, Carine
Format: Article
Language:English
Subjects:
Adolescent
Adult
adverse selection
Aged
Aged, 80 and over
Algorithms
Belgium
Coverage
Economic models
Equality
equality of access
Female
Health care access
Health economics
Health insurance
Health Services - utilization
Health Services Accessibility
Health Surveys
Healthcare Disparities
healthcare use
hospital spells
Hospitals
Humans
Impact analysis
Insurance Coverage - organization & administration
Insurance, Health
Male
Middle Aged
moral hazard
Private Sector
Socioeconomic factors
State Medicine
Studies
supplemental insurance
Young Adult
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Summary:The effects of supplemental health insurance on health‐care consumption crucially depend on specific institutional features of the health‐care system. We analyse the situation in Belgium, a country with a very broad coverage in compulsory social health insurance and where supplemental insurance mainly refers to extra‐billing in hospitals. Within this institutional background, we find only weak evidence of adverse selection in the coverage of supplemental health insurance. We find much stronger effects of socio‐economic background. We estimate a bivariate probit model and cannot reject the assumption of exogeneity of insurance availability for the explanation of health‐care use. A count model for hospital care shows that supplemental insurance has no significant effect on the number of spells, but a negative effect on the number of nights per spell. We comment on the implications of our findings for equality of access to health care in Belgium. Copyright © 2009 John Wiley & Sons, Ltd.
ISSN:1057-9230
1099-1050
DOI:10.1002/hec.1478