Wählbare Selbstbehalte in der Krankenversicherung der Schweiz: Nachfragesteuerung oder Selektion?

This paper discusses if the choice of a higher deductible in mandatory Swiss health insurance leads to a reduction of health care utilization. A GMM estimator which takes into account the potential endogeneity of the choice of the deductible is used to analyze the number of physician visits. The data from the Swiss Health Survey 2002 allow for a correct modeling of the sequence of choice of the deductible and ensuing health care utilization. Individuals were interviewed at the time of choice of the deductible and six months later. The results indicate that the observed lower number of physician visits among individuals who opted for a high deductible is caused by self-selection of healthier individuals and of individuals with less preference for health care into contracts with high deductibles. An incentive induced behavioral change towards a more parsimonious utilization of health care services cannot be found