Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare
CentER Discussion Paper No. 2017-049
57 Pages Posted: 16 Dec 2017 Last revised: 18 Dec 2017
Date Written: December 14, 2017
Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013. We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure.
Keywords: deductible, rebate, cost-sharing, healthcare consumption, regression discontinuity design, panel data
JEL Classification: I11, I13
Suggested Citation: Suggested Citation