Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare

TILEC Discussion Paper No. 2017-039

CentER Discussion Paper No. 2017-049

57 Pages Posted: 16 Dec 2017 Last revised: 18 Dec 2017

See all articles by Minke Remmerswaal

Minke Remmerswaal

Tilburg University, Tilburg Law School, Tilburg Law and Economics Center (TILEC), Students

Jan Boone

Tilburg University - Center for Economic Research (CentER); Centre for Economic Policy Research (CEPR); TILEC

Michiel J. Bijlsma

CPB Netherlands Bureau of Economic Policy Analysis; Tilburg Law and Economics Center (TILEC)

Rudy Douven

CPB Netherlands Bureau for Economic Policy Analysis; CPB Netherlands Bureau for Economic Policy Analysis

Multiple version iconThere are 2 versions of this paper

Date Written: December 14, 2017

Abstract

Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013. We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure.

Keywords: deductible, rebate, cost-sharing, healthcare consumption, regression discontinuity design, panel data

JEL Classification: I11, I13

Suggested Citation

Remmerswaal, Minke and Boone, Jan and Bijlsma, Michiel J. and Douven, Rudy, Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare (December 14, 2017). TILEC Discussion Paper No. 2017-039. Available at SSRN: https://ssrn.com/abstract=3087821 or http://dx.doi.org/10.2139/ssrn.3087821

Minke Remmerswaal

Tilburg University, Tilburg Law School, Tilburg Law and Economics Center (TILEC), Students ( email )

Warandelaan 2
Netherlands

Jan Boone (Contact Author)

Tilburg University - Center for Economic Research (CentER) ( email )

P.O. Box 90153
Tilburg, 5000 LE
Netherlands
+31 13 466 2399 (Phone)
+31 13 466 3042 (Fax)

Centre for Economic Policy Research (CEPR)

London
United Kingdom

TILEC ( email )

Warandelaan 2
Tilburg, 5000 LE
Netherlands

Michiel J. Bijlsma

CPB Netherlands Bureau of Economic Policy Analysis ( email )

P.O. Box 80510
2508 GM The Hague, 2585 JR
Netherlands

Tilburg Law and Economics Center (TILEC)

Warandelaan 2
Tilburg, 5000 LE
Netherlands

Rudy Douven

CPB Netherlands Bureau for Economic Policy Analysis ( email )

P.O. Box 80510
The Hague, 2508 GM
Netherlands

HOME PAGE: http://www.cpb.nl/nl/org/homepages/rcmhd/

CPB Netherlands Bureau for Economic Policy Analysis ( email )

P.O. Box 80510
The Hague, 2508 GM
Netherlands

HOME PAGE: http://www.cpb.nl/nl/org/homepages/rcmhd/

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