국가전략정보포털

Title page

Contents

Abstract 3

1. Introduction 4

2. Institutional Setting 8

3. Data 9

4. Model 12

4.1. Overview 12

4.2. Healthcare needs 13

4.3. Out-of-pocket payments and non-medical costs 13

4.4. Preferences 14

4.5. Patient decisions 15

4.6. Discussion 16

5. Identification and estimation 19

5.1. Identification 19

5.2. Estimation 22

6. Results 23

6.1. Parameter estimates 23

6.2. Model fit 25

7. Patient cost-sharing, redistribution, and welfare 27

7.1. Policy options 27

7.2. Overall effects of counterfactual policies 29

7.3. Redistribution between risk groups 32

7.4. Welfare 36

7.5. Robustness 38

8. Conclusion 40

References 42

Online Appendix 45

A. Additional tables and figures 46

B. Technical Details 58

Table 1. Summary statistics 11

Table 2. Parameter estimates 24

Table 3. Effects of counterfactual policies in estimation sample 30

Table 4. Overall effects of counterfactual policies 31

Table 5. Spending by risk score in full sample 33

Table 6. Redistribution between risk groups in full sample 34

Table 7. Welfare in full sample 37

Figure 1. Identification 20

Figure 2. Model fit 26

Figure 3. Policy effects 35

Table A.1. Summary statistics for 10% highest spenders 47

Table A.2. Probability of not going with a healthcare need in estimation sample 52

Table A.3. Spending by risk score in estimation sample 53

Table A.4. Redistribution in estimation sample 55

Table A.5. Welfare in estimation sample 56

Table A.6. OOP by risk score quartile in estimation sample 57

Table A.7. Std. OOP by risk score quartile in estimation sample 57

Figure A.1. Months with more than €500 spending by decile yearly spending 46

Figure A.2. Spending if positive 48

Figure A.3. Probability of any spending 49

Figure A.4. Probability of any spending if spending in t - 1 50

Figure A.5. Intensive margin fit 51

Figure A.6. Spending changes across different donut hole contracts 54