Title: Out-of-pocket payments and their effects on the expenditure structure of private households

Authors: Birte Erdmann

Addresses: Economy and Demography, Institute for Gerontology, University of Vechta, Driverstraße 22 D – 49377 Vechta, Germany

Abstract: Nearly everyone insured by the German Statutory Health Insurance (SHI) is affected by one or more co-payments. The practise fee, which SHI-insured people have to pay at each quarter's initial visit to a doctor, is perhaps the most common co-payment. This was regularised in 2003 by the federal government, among other measures, to reduce costs that arise from the so-called ex-post moral hazard problem (i.e., usage of more healthcare because the insurance bears the costs). With other co-payments, this change could mean a change in consumer habits. Therefore, an empirical analysis of the German sample surveys of income and expenditure of 2003 and 2008 was done. The results indicate that because of the introduced measures the expenditure structure of private households has changed.

Keywords: out-of-pocket payments; co-payments; practise fees; private health expenditure; healthcare systems; Statutory Health Insurance; SHI; healthcare reform; private households; expenditure structure; moral hazard; Germany.

DOI: 10.1504/IJBHR.2012.046726

International Journal of Behavioural and Healthcare Research, 2012 Vol.3 No.2, pp.152 - 166

Available online: 18 Apr 2012 *

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