Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare

59 Pages Posted: 19 Dec 2017

See all articles by Michiel Bijlsma

Michiel Bijlsma

De Nederlandsche Bank; Tilburg Law and Economics Center (TILEC)

Jan Boone

Tilburg University - Center for Economic Research (CentER); Centre for Economic Policy Research (CEPR); TILEC

Rudy Douven

CPB Netherlands Bureau for Economic Policy Analysis; CPB Netherlands Bureau for Economic Policy Analysis

Minke Remmerswaal

Tilburg University, Tilburg Law School, Tilburg Law and Economics Center (TILEC), Students

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Date Written: December 2017

Abstract

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: cost-sharing, deductible, healthcare consumption, panel data, rebate, regression discontinuity design

Suggested Citation

Bijlsma, Michiel and Boone, Jan and Douven, Rudy and Remmerswaal, Minke, Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare (December 2017). CEPR Discussion Paper No. DP12507, Available at SSRN: https://ssrn.com/abstract=3089764

Michiel Bijlsma (Contact Author)

De Nederlandsche Bank ( email )

Netherlands

Tilburg Law and Economics Center (TILEC)

Warandelaan 2
Tilburg, 5000 LE
Netherlands

Jan Boone

Tilburg University - Center for Economic Research (CentER) ( email )

P.O. Box 90153
Tilburg, 5000 LE
Netherlands
+31 13 466 2399 (Phone)
+31 13 466 3042 (Fax)

Centre for Economic Policy Research (CEPR)

London
United Kingdom

TILEC ( email )

Warandelaan 2
Tilburg, 5000 LE
Netherlands

Rudy Douven

CPB Netherlands Bureau for Economic Policy Analysis ( email )

P.O. Box 80510
The Hague, 2508 GM
Netherlands

HOME PAGE: http://www.cpb.nl/nl/org/homepages/rcmhd/

CPB Netherlands Bureau for Economic Policy Analysis ( email )

P.O. Box 80510
The Hague, 2508 GM
Netherlands

HOME PAGE: http://www.cpb.nl/nl/org/homepages/rcmhd/

Minke Remmerswaal

Tilburg University, Tilburg Law School, Tilburg Law and Economics Center (TILEC), Students ( email )

Warandelaan 2
Netherlands

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