Supplemental Health Insurance and Equality of Access in Belgium

Posted: 20 Jun 2007

See all articles by Erik Schokkaert

Erik Schokkaert

Catholic University of Leuven (KUL)

Tom Van Ourti

Erasmus University Rotterdam (EUR); Tinbergen Institute

Diana De Graeve

University of Antwerp

Ann Lecluyse

University of Antwerp

Carine Van de Voorde

Catholic University of Leuven (KULeuven)

Date Written: August 2007

Abstract

It has been suggested that the unequal coverage of different socio-economic groups by supplemental insurance could be a partial explanation for the inequality in access to health care in many countries. 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. We find that this institutional background is crucial for the explanation of the effects of supplemental insurance. We find no evidence of adverse selection in the coverage of supplemental health insurance, but strong effects of socio-economic background. 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. This is in line with patterns of socio-economic stratification that have been well documented for Belgium. It is also in line with the regulation on extra-billing protecting patients in common rooms. For ambulatory care, we find a positive effect of supplemental insurance on visits to a dentist and on number of spells at a day centre but no effect on visits to a GP, on drugs consumption and on visits to a specialist.

Keywords: supplemental insurance, adverse selection, moral hazard, hospital spells, equality of access, health care use

Suggested Citation

Schokkaert, Erik and Van Ourti, Tom and De Graeve, Diana and Lecluyse, Ann and Van de Voorde, Carine, Supplemental Health Insurance and Equality of Access in Belgium (August 2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=994803 or http://dx.doi.org/10.2139/ssrn.994803

Erik Schokkaert (Contact Author)

Catholic University of Leuven (KUL) ( email )

Oude Markt 13
Leuven, Vlaams-Brabant 3000
Belgium

Tom Van Ourti

Erasmus University Rotterdam (EUR) ( email )

Burgemeester Oudlaan 50
3000 DR Rotterdam, Zuid-Holland 3062PA
Netherlands

Tinbergen Institute ( email )

Burg. Oudlaan 50
Rotterdam, 3062 PA
Netherlands

Diana De Graeve

University of Antwerp ( email )

Prinsstraat 13
Antwerp, Antwerp 2000
Belgium

Ann Lecluyse

University of Antwerp ( email )

Prinsstraat 13
Antwerp, Antwerp 2000
Belgium

Carine Van de Voorde

Catholic University of Leuven (KULeuven) ( email )

Naamsestraat 69
B-3000 Leuven, 3000
Belgium

Here is the Coronavirus
related research on SSRN

Paper statistics

Abstract Views
782
PlumX Metrics