Rationale: The Italian National Health Service (INHS) provides cares according to universalistic principles based on uniform standards of quality. In such a contest private health insurance (PHI) should provide some added value to find an adequate market space. At present there is a large debate on how to incentive PHI and the possible advantages for the welfare system. Objectives: The objective of this paper is to analyse the role of PHI policies both to reduce the burden of health related out of pocket consumption (OOP) and to integrate INHS coverage. Methodology: There will be an estimate of the degree of coverage provided by PHI. This will be done elaborating micro-data from both the households budget survey carried out by Bank of Italy (on a sample of around 8,000 households) and from the survey on households consumption annually provided by the Italian National Institute for Statistics (on a sample of around 25,000 households). This analysis will be carried out considering Analysis of variance (ANOVA) to provide evidences of low impact of PHI on OOP and the T-test to show level and significance of the mean differences in OOP expenditure levels between insured and uninsured households. Moreover OOP distribution will be analysed. Results: The differences between insured and uninsured households OOP, in the sample considered, vary from 36 Euros to 96 Euros, average premiums for PHI are between 390 Euros and 530 Euros for each person (ANIA) and effective average health expenditure stays between 1,344 Euros and 3,096 Euros. Moreover the 40% of richest households contains the 74.2% of insured households and affords the 67.3% of private out of pocket expenditures. The study of the distribution of OOP provides evidences on both the presence of expensive tastes in the sub sample of insured households and on the request by richest households for opting out of the system. There is even evidence of the failure of the universalistic health system in covering some kind of expenditures (like dental care for instance). Conclusions: We conclude that it will be worthwhile to incentive the sector, in order to enlarge the number of households insured, and in this way increasing risk pooling. We observe that the fiscal incentive should focus on services not adequately provided by the INHS in order to avoid duplication of costs.

Borgia, P., Doglia, M., Spandonaro, F. (2006). Reasons for private health insurance in a universalistic national health service. In IHEA (a cura di), IHEA 2007 6th World Congress: explorations in health economics Paper. International Health Economics ASSN World Congress.

Reasons for private health insurance in a universalistic national health service

SPANDONARO, FEDERICO
2006-01-01

Abstract

Rationale: The Italian National Health Service (INHS) provides cares according to universalistic principles based on uniform standards of quality. In such a contest private health insurance (PHI) should provide some added value to find an adequate market space. At present there is a large debate on how to incentive PHI and the possible advantages for the welfare system. Objectives: The objective of this paper is to analyse the role of PHI policies both to reduce the burden of health related out of pocket consumption (OOP) and to integrate INHS coverage. Methodology: There will be an estimate of the degree of coverage provided by PHI. This will be done elaborating micro-data from both the households budget survey carried out by Bank of Italy (on a sample of around 8,000 households) and from the survey on households consumption annually provided by the Italian National Institute for Statistics (on a sample of around 25,000 households). This analysis will be carried out considering Analysis of variance (ANOVA) to provide evidences of low impact of PHI on OOP and the T-test to show level and significance of the mean differences in OOP expenditure levels between insured and uninsured households. Moreover OOP distribution will be analysed. Results: The differences between insured and uninsured households OOP, in the sample considered, vary from 36 Euros to 96 Euros, average premiums for PHI are between 390 Euros and 530 Euros for each person (ANIA) and effective average health expenditure stays between 1,344 Euros and 3,096 Euros. Moreover the 40% of richest households contains the 74.2% of insured households and affords the 67.3% of private out of pocket expenditures. The study of the distribution of OOP provides evidences on both the presence of expensive tastes in the sub sample of insured households and on the request by richest households for opting out of the system. There is even evidence of the failure of the universalistic health system in covering some kind of expenditures (like dental care for instance). Conclusions: We conclude that it will be worthwhile to incentive the sector, in order to enlarge the number of households insured, and in this way increasing risk pooling. We observe that the fiscal incentive should focus on services not adequately provided by the INHS in order to avoid duplication of costs.
Settore SECS-P/06 - Economia Applicata
English
Rilevanza internazionale
Articolo scientifico in atti di convegno
private insurance health expenditures; public policies
Borgia, P., Doglia, M., Spandonaro, F. (2006). Reasons for private health insurance in a universalistic national health service. In IHEA (a cura di), IHEA 2007 6th World Congress: explorations in health economics Paper. International Health Economics ASSN World Congress.
Borgia, P; Doglia, M; Spandonaro, F
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/126282
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