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Co‐Pay and Feel Okay: Self‐Rated Health Status After a Health Insurance Reform
Author(s) -
Paloyo Alfredo R.
Publication year - 2014
Publication title -
social science quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.482
H-Index - 90
eISSN - 1540-6237
pISSN - 0038-4941
DOI - 10.1111/ssqu.12027
Subject(s) - natural experiment , payment , actuarial science , health insurance , health reform , ambulatory , public health , medical prescription , german , business , public economics , demographic economics , economics , medicine , health care , economic growth , nursing , finance , archaeology , pathology , history
Objective The reliability of general self‐rated health status is examined using the reform of the public health insurance system of Germany in 2004 as a source of exogenous variation. The reform introduced a co‐payment for ambulatory doctor visits and increased the co‐payments for prescription drugs. Methods This natural experiment allows identification of the causal impact of the program on self‐assessed health (SAH). A difference‐in‐differences estimator is applied to estimate the effect of the reform on SAH. Results Using data from the German Socio‐Economic Panel, the results indicate that the reform improved the treatment group's average SAH even when there was no discernible impact on actual health. Conclusion The exercise reveals the sensitivity of SAH to a perturbation in the insurance system. More objective measures of health may be needed to acquire an accurate assessment of general health when the health system is in flux.