Utilisation and Selection in an Ancillaries Health Insurance Market

36 Pages Posted: 28 Oct 2016

Date Written: October 27, 2016


I study two important aspects of the Australian private ancillaries health insurance (PAHI) market. First, I estimate the effect of PAHI on utilisation of various health services using instrumental variable methods to identify causal effects. Next I test for the presence and direction of selection effects by identifying variables not used in pricing that influence both the insurance and utilisation decision. PAHI covers a wide range of out-of-hospital health services, including many discretionary and preventative services. The most quantitatively important are dental, optometry, physiotherapy and chiropractic. I find that PAHI does increase utilisation of health services, particularly the probability of visiting a dentist, physiotherapist, chiropractor, osteopath or acupuncturist. I find evidence of selection effects in the sense that a number of different variables can predict a person’s propensity to insure as well as their propensity to utilise health services. The variables that I identify generally result in adverse selection to insurers for higher frequency health services, although selection bias is more heterogeneous for lower frequency services. There is little evidence of self-selection based on the joint probability of different health services, which indicates that diversified policy menus are a possible strategy for addressing adverse selection in the PAHI market.

Keywords: Health Insurance, Moral Hazard, Adverse Selection, Favourable Selection

JEL Classification: I13, D82

Suggested Citation

Kettlewell, Nathan, Utilisation and Selection in an Ancillaries Health Insurance Market (October 27, 2016). UNSW Business School Research Paper No. 2016-17, Available at SSRN: https://ssrn.com/abstract=2860361 or http://dx.doi.org/10.2139/ssrn.2860361

Nathan Kettlewell (Contact Author)

University of Sydney ( email )

Rm 370 Merewether (H04)
The University of Sydney
Sydney, NSW 2006 2008

HOME PAGE: http://sydney.edu.au/arts/economics/staff/profiles/nathan.kettlewell.php

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