Skip to main content

Advertisement

SpringerLink
Log in

Consumer preferences in social health insurance

  • Original Paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans which differed in 12 characteristics (premium, deductibles, no-claim discount, extension of insurance and financial services, red tape involved, medical help-desk, choice of family physicians and hospitals, dental benefits, physical therapy benefits, benefits for prescription drugs and homeopathy). In 90% the health plan with the most attractive characteristics was preferred, indicating a predominantly rational kind of choice. The most decisive characteristics for preference were: complete dental benefits, followed by zero deductibles, and free choice of hospitals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Altenstetter C, Bjorkman JW (1997) Health policy reform, national variations and globalization. London: MacMillan

  2. Barringer MW, Mitchell OS (1994) Workers’ preferences among provided health insurance plans. Ind Labor Relations Rev 48:141–152

    Google Scholar 

  3. Booske BC, Sainfort F, Schoofs Hundt A (1999) Eliciting consumer preferences for health plans. Health Serv Res 34:839–854

    CAS  PubMed  Google Scholar 

  4. Buchmueller TC, Feldstein PJ (1996) Consumer’s sensitivity to health plan premiums: evidence from a natural experiment in California. Health Aff (Millwood) 15:143 151

    Google Scholar 

  5. Chakraborty G, Ettenson R, Gaeth G (1994) How consumers choose health insurance. J Health Care Mark 14:21–33

    CAS  PubMed  Google Scholar 

  6. Colombo F (2001) Towards more choice in social protection? Individual choice of insurer in basic mandatory health insurance in Switzerland. Labour market and social policy occasional papers no. 53, Paris: OECD

  7. Cunningham PJ, Kohn L (2000) Health plan switching: choice or circumstance? Health Aff (Millwood) 19:158–164

    Google Scholar 

  8. Cunningham PJ, Denk C, Sinclair M (2001) Do consumers know how their health plan works? Health Aff (Millwood) 20:159–166

    Google Scholar 

  9. Cutler DM, Reber SJ (1998) Paying for health insurance: the trade-off between competition and adverse selection. Q J Econ 113:433–466

    Article  Google Scholar 

  10. Dowd B, Feldman R (1994) Premium elasticities of health plan choice. Inquiry 31:438–444

    CAS  PubMed  Google Scholar 

  11. Enthoven AC (1993) The history and principles of managed competition. Health Aff (Millwood) 12 [Suppl]:24–48

  12. Feldman R, Finch M, Dowd B, Cassou S (1989) The demand for employment based health insurance plans. J Human Res 24:115–142

    Google Scholar 

  13. Gibbs DA, Sangl JA, Burrus B (1996) Consumer perspectives on information needs for health plan choice. Health Care Financ Rev 18:55–73

    CAS  PubMed  Google Scholar 

  14. Gress S, Groenewegen P, Kerssens J, Braun B, Wasem J (2002) Free choice of sickness funds in regulated competition: evidence from Germany and The Netherlands. Health Policy 60:235–254

    Article  PubMed  Google Scholar 

  15. Hershey JC, Kunreuther H, Schwartz JS, Williams SV (1984) Health insurance under competition: would people choose what is expected? Inquiry 21:349–360

    CAS  PubMed  Google Scholar 

  16. Hibbard JH, Jewett JJ (1997) Will quality report cards help consumers? Health Aff (Millwood) 16:218–228

    Article  CAS  Google Scholar 

  17. Kerssens JJ, Groenewegen PP (2003) Consumer choice of social health insurance in managed competition. Health Expect 312–322

  18. Kerssens JJ, Delnoij DMJ, Verweij JA, Schee E van der (2002) De keuze van ziekenfondsverzekerden voor een zorgverzekeraar (consumer preferences for particular social health insurers). Tijdschr Soc Gezondheidszorg 80:35–42

    Google Scholar 

  19. Lamers LM, Vliet RCJA van, Ven WPMM van de (2003) Risk adjustment premium subsidies and risk sharing: key elements of the competitive sickness fund market in the Netherlands. Health Policy 65:49–62

    Article  PubMed  Google Scholar 

  20. Lieverdink H (2000) The marginal success of regulated competition policy in The Netherlands. Soc Sci Med 52:1183–1194

    Article  Google Scholar 

  21. Light DW (2001) Comparative institutional response to economic policy managed competition and governmentality. Soc Sci Med 52:1151–1166

    Article  CAS  PubMed  Google Scholar 

  22. Long SH, Settle RF, Wrightson CW (1988) Employee premiums, availability of alternative plans, and HMO disenrollment. Med Care 26:927–938

    CAS  PubMed  Google Scholar 

  23. McGuire TG (1981) Price and membership in a prepaid group medical practice. Med Care 19:172–183

    CAS  PubMed  Google Scholar 

  24. Robinson S, Brodie M (1997) Understanding the quality challenge for health consumers: the Kaiser/AHCPR Survey. J Qual Improv 23:239–244

    CAS  Google Scholar 

  25. Royalty AB, Solomon N (1999) Health plan choice. Price elasticities in a managed competition setting. J Human Res 34:1–41

    Google Scholar 

  26. Rutten F, Buschbach J van (2001) How to define a basic package of health services for a tax funded or social insurance based health care system? Eur J Health Econ 2:45–46

    Google Scholar 

  27. Ryan M, Bate A, Eastmond CJ, Ludbrook A (2001) Use of discrete choice experiments to elicit preferences. Qual Health Care 10 [Suppl 1]:i55–i60

  28. Ryan M, McIntosh E, Shackley P (1998) Using conjoint analyses to elicit the views of health service users: an application to the patient card. Health Expect 1:117–129

    Article  PubMed  Google Scholar 

  29. Scammon DL (1989) Self-funded health benefits plans: marketing implications for PPOs and employers. J Health Care Mark 9:5–14

    CAS  Google Scholar 

  30. Scanlon DP, Chernew M, Lave JR (1997) Consumer health plan choice: current knowledge and future directions. Annu Rev Public Health 507–28

    Google Scholar 

  31. Schut FT (1996) Health care systems in transition: The Netherlands. I. Health care reforms in The Netherlands: miracle or mirage? J Pub Health Med 18:278–284

    CAS  Google Scholar 

  32. Schut FT, Doorslaer EKA van (1999) Towards a reinforced agency role of health insurers in Belgium and the Netherlands. Health Policy 48:47–67

    Article  CAS  PubMed  Google Scholar 

  33. Schut FT, Hassink WHJ (2002) Managed competition and consumer price sensitivity in social health insurance. J Health Econ 21:1009–1029

    Article  PubMed  Google Scholar 

  34. Short PF, Taylor AK (1989) Premiums, benefits, and employee choice of health insurance options. J Health Econ 8:293–311

    Article  CAS  PubMed  Google Scholar 

  35. Smith HL, Rogers RD (1986) Factors influencing consumers’ selection of health insurance carriers. J Health Care Mark 6:6–14

    CAS  PubMed  Google Scholar 

  36. Ven WPPM van de (2001) Risk selection on the sickness fund market. Eur J Health Econ 2:91–95

    Google Scholar 

  37. ZFR/CTU (1999) Onderzoek effecten aanvullende verzekering (investigation of the effects of supplementary insurance). Amstelveen: ZFR/CTU

Download references

Acknowledgement

This study was supported financially by the organization of VGZ-zorgverzekeraar (VGZ healthcare insurers).

Conflict of interest:

No information supplied

Author information

Authors and Affiliations

  1. Netherlands Institute for Health Services Research, Utrecht, The Netherlands

    Jan J. Kerssens & Peter P. Groenewegen

  2. Department of Human Geography and Department of Sociology, Utrecht University, Utrecht, The Netherlands

    Peter P. Groenewegen

  3. Netherlands Institute for Health Services Research NIVEL, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands

    Jan J. Kerssens

Authors
  1. Jan J. Kerssens
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter P. Groenewegen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan J. Kerssens.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kerssens, J.J., Groenewegen, P.P. Consumer preferences in social health insurance. Eur J Health Econ 6, 8–15 (2005). https://doi.org/10.1007/s10198-004-0252-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-004-0252-3

Keywords

Search

Navigation