Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?

The aim of this article is to estimate the type of selection that exists in the voluntary health insurance market in Colombia where the compulsory coverage is implemented through a managed care competition. We build a panel database that combines individuals¿ information from the Ministry of Health...

Full description

Autores:
Bardey, David
Buitrago Gutiérrez, Giancarlo
Tipo de recurso:
Work document
Fecha de publicación:
2016
Institución:
Universidad de los Andes
Repositorio:
Séneca: repositorio Uniandes
Idioma:
eng
OAI Identifier:
oai:repositorio.uniandes.edu.co:1992/8699
Acceso en línea:
http://hdl.handle.net/1992/8699
Palabra clave:
Information asymmetry
Health insurance
Adverse Selection
Correlation test
Seguros de salud - Colombia - Modelos econométricos
Información asimétrica - Investigaciones - Colombia
Plan obligatorio de salud - Colombia
D82, I13, G22
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-nd/4.0/
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oai_identifier_str oai:repositorio.uniandes.edu.co:1992/8699
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dc.title.none.fl_str_mv Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
dc.title.alternative.none.fl_str_mv Aseguramiento voluntario en el Sistema de Salud de Colombia : ¿Selección adversa o ventajosa?
title Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
spellingShingle Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
Information asymmetry
Health insurance
Adverse Selection
Correlation test
Seguros de salud - Colombia - Modelos econométricos
Información asimétrica - Investigaciones - Colombia
Plan obligatorio de salud - Colombia
D82, I13, G22
title_short Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
title_full Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
title_fullStr Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
title_full_unstemmed Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
title_sort Supplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?
dc.creator.fl_str_mv Bardey, David
Buitrago Gutiérrez, Giancarlo
dc.contributor.author.none.fl_str_mv Bardey, David
Buitrago Gutiérrez, Giancarlo
dc.subject.keyword.none.fl_str_mv Information asymmetry
Health insurance
Adverse Selection
Correlation test
topic Information asymmetry
Health insurance
Adverse Selection
Correlation test
Seguros de salud - Colombia - Modelos econométricos
Información asimétrica - Investigaciones - Colombia
Plan obligatorio de salud - Colombia
D82, I13, G22
dc.subject.armarc.none.fl_str_mv Seguros de salud - Colombia - Modelos econométricos
Información asimétrica - Investigaciones - Colombia
Plan obligatorio de salud - Colombia
dc.subject.jel.none.fl_str_mv D82, I13, G22
description The aim of this article is to estimate the type of selection that exists in the voluntary health insurance market in Colombia where the compulsory coverage is implemented through a managed care competition. We build a panel database that combines individuals¿ information from the Ministry of Health and a database provided by two private health insurers. We perform the correlation test for health expenditure and coverage. Following Fang et al. (2008), we condition the estimation on health controls that are available to the econometrician but not to insurers. In both cases we obtain a positive correlation, suggesting that adverse selection predominates. In order to rule out some moral hazard effects, we estimate the correlation between previous health service consumption and insurance purchase. The positive correlation obtained is robust to the inclusion of controls for diagnosis, suggesting that despite some risk selection strategies, health insurers are not protected from adverse selection.
publishDate 2016
dc.date.issued.none.fl_str_mv 2016
dc.date.accessioned.none.fl_str_mv 2018-09-27T16:56:03Z
dc.date.available.none.fl_str_mv 2018-09-27T16:56:03Z
dc.type.spa.fl_str_mv Documento de trabajo
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dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/1992/8699
dc.identifier.eissn.none.fl_str_mv 1657-7191
dc.identifier.doi.none.fl_str_mv 10.57784/1992/8699
dc.identifier.instname.spa.fl_str_mv instname:Universidad de los Andes
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url http://hdl.handle.net/1992/8699
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.ispartofseries.none.fl_str_mv Documentos CEDE No. 32 Octubre de 2016
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dc.format.extent.none.fl_str_mv 17 páginas
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dc.publisher.none.fl_str_mv Universidad de los Andes, Facultad de Economía, CEDE
publisher.none.fl_str_mv Universidad de los Andes, Facultad de Economía, CEDE
institution Universidad de los Andes
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spelling Al consultar y hacer uso de este recurso, está aceptando las condiciones de uso establecidas por los autores.http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Bardey, Davideb5d55eb-0c4d-4330-b74c-b4e0ef0037ac500Buitrago Gutiérrez, Giancarlo3e055515-b468-4668-b35f-e9312977a7555002018-09-27T16:56:03Z2018-09-27T16:56:03Z20161657-5334http://hdl.handle.net/1992/86991657-719110.57784/1992/8699instname:Universidad de los Andesreponame:Repositorio Institucional Sénecarepourl:https://repositorio.uniandes.edu.co/The aim of this article is to estimate the type of selection that exists in the voluntary health insurance market in Colombia where the compulsory coverage is implemented through a managed care competition. We build a panel database that combines individuals¿ information from the Ministry of Health and a database provided by two private health insurers. We perform the correlation test for health expenditure and coverage. Following Fang et al. (2008), we condition the estimation on health controls that are available to the econometrician but not to insurers. In both cases we obtain a positive correlation, suggesting that adverse selection predominates. In order to rule out some moral hazard effects, we estimate the correlation between previous health service consumption and insurance purchase. The positive correlation obtained is robust to the inclusion of controls for diagnosis, suggesting that despite some risk selection strategies, health insurers are not protected from adverse selection.El objetivo de este artículo es determinar el tipo de selección predominante que existe en el mercado de seguros voluntarios de salud en Colombia, donde la cobertura obligatoria es implementada a través de managed care competition. Construimos una base de datos tipo panel que combina información individual del Ministerio de Salud y Protección Social con información de dos aseguradoras que ofrecen ambos niveles de cobertura. Primero, realizamos la prueba de correlación entre gastos en salud y cobertura. Luego, siguiendo a Fang et al. (2008), incluimos en la estimación controles del estado de salud de los individuos, información disponible para el econometrista pero no para el asegurador. En ambas estimaciones obtenemos un resultado positivo de la correlación, lo que sugiere que la selección adversa predomina en este escenario. Con el objetivo de excluir efectos de riesgo moral que pudieran explicar estos resultados, estimamos la correlación entre el consumo previo de servicios de salud y la compra del seguro. La correlación positiva obtenida es robusta a la inclusión de controles de diagnóstico, resultado que sugiere que la presencia de estrategias de selección de riesgo por parte de las aseguradoras no protege de la selección adversa.17 páginasapplication/pdfengUniversidad de los Andes, Facultad de Economía, CEDEDocumentos CEDE No. 32 Octubre de 2016https://ideas.repec.org/p/col/000089/015138.htmlSupplementary health insurance in the Colombian managed care system : ¿adverse or advantageous selection?Aseguramiento voluntario en el Sistema de Salud de Colombia : ¿Selección adversa o ventajosa?Documento de trabajoinfo:eu-repo/semantics/workingPaperhttp://purl.org/coar/resource_type/c_8042http://purl.org/coar/version/c_970fb48d4fbd8a85Texthttps://purl.org/redcol/resource_type/WPInformation asymmetryHealth insuranceAdverse SelectionCorrelation testSeguros de salud - Colombia - Modelos econométricosInformación asimétrica - Investigaciones - ColombiaPlan obligatorio de salud - ColombiaD82, I13, G22Facultad de EconomíaPublicationTHUMBNAILdcede2016-32.pdf.jpgdcede2016-32.pdf.jpgIM Thumbnailimage/jpeg33867https://repositorio.uniandes.edu.co/bitstreams/a3117218-29d9-49e5-a103-20f134f64a5e/download186ddcf0f39424507b52c7fcbcd82ccfMD55TEXTdcede2016-32.pdf.txtdcede2016-32.pdf.txtExtracted texttext/plain43385https://repositorio.uniandes.edu.co/bitstreams/68c5ca92-ba9d-484d-8341-a84503ff7447/download508d67e6e0b71cafc97c21cd491f5f07MD54ORIGINALdcede2016-32.pdfdcede2016-32.pdfapplication/pdf693355https://repositorio.uniandes.edu.co/bitstreams/bfb277e2-19d4-48c6-b245-16b076f186d8/download6d2a87552a71d9a865e43994498c1393MD511992/8699oai:repositorio.uniandes.edu.co:1992/86992024-06-04 15:30:16.276http://creativecommons.org/licenses/by-nc-nd/4.0/open.accesshttps://repositorio.uniandes.edu.coRepositorio institucional Sénecaadminrepositorio@uniandes.edu.co