Bonus Options in Health Insurance

1. Front Matter

   Pages i-xii

   PDF

2. Overview and key statements of the study

   • Peter Zweifel

   Pages 1-7

3. Institutional framework, issues, and results

   • Peter Zweifel

   Pages 8-16

4. Health insurance options from the point of view of the consumer

   • Peter Zweifel

   Pages 17-24

5. Insurer A: Traditional cost sharing

   • Peter Zweifel

   Pages 25-41

6. Insurer B: Fixed rebates for no claims

   • Peter Zweifel

   Pages 42-63

7. Self-selection of risks with insurers A and B?

   • Peter Zweifel

   Pages 64-69

8. Insurer C: The dynamic bonus system

   • Peter Zweifel

   Pages 70-78

9. First-dollar coverage, fixed rebate, and dynamic bonus compared

   • Peter Zweifel

   Pages 79-103

10. Bonus options in social health insurance?

    • Peter Zweifel

    Pages 104-111

11. Back Matter

    Pages 112-143

    PDF

Confronted with the continuing cost expansion in the health care sector, policy makers face a dilemma: limiting moral hazard in medical care requires that consumers participate in the cost, yet copayment is strongly resisted by today's socially insured. Thus, the experiences of three private German health insurers will be of interest to physicians, social scientists, and policy makers. Insurer A writes conventional plans with deductibles and coinsurance; B pays back three-monthly premiums as a fixed rebate for no claims; while C runs an experience-rated bonus system starting with a rebate of three-monthly premiums for the first year without a claim, reaching a maximum of five after three years. While both rebates and bonuses are quite popular among insureds, this study shows that bonus options are particularly effective in limiting the demand for ambulatory and even hospital care. But what about adverse effects on health caused by the desire to save one's bonus? On this issue, there is some surprising evidence.

• health
• health care
• hospital

'It is an economic study as it should be: clear questions are raised, hypotheses are derived from theoretical models, and the hypotheses are tested with empirical data.' Health Economics 2:1 1993

• Department of Economics, University of Zürich, Switzerland

  Peter Zweifel

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