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KMID : 1170320100160010139
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Korean Journal of Health Economics and Policy
2010 Volume.16 No. 1 p.139 ~ p.159
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The impact of having private health insurance on healthcare utilization with controlling for endogeneity
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Kang Sung-Wook
You Chang-Hoon
Oh Eun-Hwan
Kwon Young-Dae
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Abstract
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Regardless of wide expansion of service coverage in public health insurance, Koreans have relied on supplementary private health insurance (PHI) to meet medical costs which they may not be able to afford. This study examined the effects of having PHI on healthcare utilization in Korea. Data from two waves of the Korean Longitudinal Study of Ageing in 2006 and 2008 were used. Subjects were limited to those who consecutively had or did not have PHI for the two waves (n=5,713). We conducted a negative binomial regression analysis to identify the effects of having PHI on physician visits and hospital admission. A method of two-step estimation was also applied to control for endogeneity of having PHI in healthcare utilization. Thirty-one percentof respondents had PHI. The average numbers of physician visit and hospital admission were 8.89 and 0.14 respectively during the past two years. A negative binomial regression analysis found that having PHI was positively related to increase the possibility of physician visit and hospital admission. On the contrary, the two-step estimation controlling for endogeneity showed no statistical relationships between the purchase of PHI and physician visit and hospital admission. Having PHI affected in part on increasing healthcare utilization. It is resulted from the insurer’s adverse selection rather than economic incentive of the nature of health insurance. To the extent that some portion of increased healthcare use was from public healthcare resources and the beneficiaries were those who have better socioeconomic status, PHI made equity worse off.
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KEYWORD
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supplementary private health insurance, adverse selection, moral hazard, endogeneity, two-step estimation
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