Assessing the Effectiveness of Health Care Cost Containment Measures

Using SOEP panel data and difference-in-differences methods, this study is the first to empirically evaluate the effectiveness of four different health care cost containment measures within an integrated framework. The four measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for convalescent care. Doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in demand of about 20 percent. Indirect measures such as allowing employers to cut statutory sick pay or paid vacation during health spa stays did not significantly reduce demand.copayment, cost containment measures, health expenditures, convalescent care, SOEP

Assessing the Effectiveness of Health Care Cost Containment Measures

Using SOEP panel data and difference-in-differences methods, this study is the first to empirically evaluate the effectiveness of four different health care cost containment measures within an integrated framework. The four measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for convalescent care. Doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in demand of about 20 percent. Indirect measures such as allowing employers to cut statutory sick pay or paid vacation during health spa stays did not significantly reduce demand.health expenditures, cost containment measures, copayment, convalescent care, SOEP

The Effects of Expanding the Generosity of the Statutory Sickness Insurance System

In 1999, in Germany, the statutory sick pay level was increased from 80 to 100 percent of foregone earnings for sicknessepisodes of up to six weeks. We show that this reform has led to an increase in average absence days of about 10 percent or one additional day per employee, per year. The estimates are based on SOEP survey data and parametric, nonparametric, and combined matching-regression difference-in-differences methods. Extended calculations suggest that the reform might have increased labor costs by about EUR1.8 billion per year and might have led to the loss of around 50,000 jobs.Sickness absence, statutory sick pay, natural experiment, Socio-Economic Panel Study (SOEP)

In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

This paper provides field evidence on (a) how price framing affects consumers' decision to switch health insurance plans and (b) how the price elasticity of demand for health insurance can be influenced by policymakers through simple regulatory efforts. In 2009, in order to foster competition among health insurance companies, German federal regulation required health insurance companies to express price differences between health plans in absolute Euro values rather than percentage point payroll tax differences. Using individual-level panel data, as well as aggregated health plan-level panel data, we find that the reform led to a sixfold increase in an individual's switching probability and a threefold demand elasticity increase.health insurance, health plan switching, price competition, price elasticity, SOEP

In Absolute or Relative Terms?: How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

This paper provides field evidence on (a) how price framing affects consumers' decision to switch health insurance plans and (b) how the price elasticity of demand for health insurance can be influenced by policymakers through simple regulatory efforts. In 2009, in order to foster competition among health insurance companies, German federal regulation required health insurance companies to express price differences between health plans in absolute Euro values rather than percentage point payroll tax differences. Using individuallevel panel data, as well as aggregated health plan-level panel data, we find that the reform led to a sixfold increase in an individual's switching probability and a threefold demand elasticity increase.Health insurance, health plan switching, price competition, price elasticity, SOEP

Revisiting the Income-Health Nexus: The Importance of Choosing the "Right" Indicator

We show that the choice of the welfare measure has a substantial impact on the degree of welfare-related health inequality. Combining various income and wealth measures with different health measures, we calculate 80 health concentration indices. The influence of the welfare measure is more pronounced when using subjective health measures than when using objective health measures.income measurement, concentration index, health inequality, SOEP

A Natural Experiment on Sick Pay Cuts, Sickness Absence, and Labor Costs

This study estimates the reform effects of a reduction in statutory sick pay levels on various outcome dimensions. A federal law reduced the legal obligation of German employers to provide 100 percent continued wages for up to six weeks per sickness episode to 80 percent. This measure increased the ratio of employees having no days of absence by about 7.5 percent. The mean number of absence days per year decreased by about 5 percent. The reform might have reduced total labor costs by about EUR1.5 billion per year which might have led to the creation of around 50,000 new jobs.

Revisiting the Income-Health Nexus: The Importance of Choosing the "Right" Indicator

We show that the choice of the welfare measure has a substantial impact on the degree of welfare-related health inequality. Combining various income and wealth measures with different health measures, we calculate 80 health concentration indices. The influence of the welfare measure is more pronounced when using subjective health measures than when using objective health measures.health inequality, concentration index, income measurement, SOEP

Langzeitkranke verlieren durch Kürzung des Krankengeldes fünf Milliarden Euro

Am 1. Januar 1997 trat eine Krankengeldkürzung von 80 auf 70 Prozent des Bruttoeinkommens in Kraft. Ab der siebten Woche erhalten gesetzlich Versicherte Krankengeld, sie gelten als langzeitkrank. Berechnungen auf Basis des Sozio-oekonomischen Panels (SOEP) zeigen, dass durch diese Maßnahme innerhalb von zehn Jahren rund fünf Milliarden Euro von den Langzeitkranken zugunsten der übrigen Versicherten umverteilt wurden. Dies trägt - wie von der Politik gewünscht - dazu bei, die Beitragssätze der gesetzlichen Krankenversicherung stabil zu halten, wenngleich der Effekt mit zuletzt 0,04 Beitragspunkten marginal ist. Durch die Krankengeldkürzung verlieren Langzeitkranke durchschnittlich 250 Euro pro Krankheitsepisode. Die Kürzung hat ursächlich nicht dazu geführt, dass die Zahl der Langzeitkrankheitsfälle von 1993 bis 2006 von 2,3 auf 1,4 Millionen gesunken ist.Long-term absenteeism, Long-term sick pay, Redistribution, SOEP

In Vino Pecunia?: The Association between Beverage-Specific Drinking Behavior and Wages

The positive association between moderate alcohol consumption and wages is well documented in the economic literature. Positive health effects as well as networking mechanisms serve as explanations for the "alcohol-income puzzle." Using individual-based microdata from the GSOEP for 2006, we confirm that this relationship exists for Germany as well. More importantly, we shed light on the alcohol-income puzzle by analyzing, for the first time, the association between beverage-specific drinking behavior and wages. In our analysis, we disentangle the general wage effect of drinking into diverse effects for different types of drinkers. Mincerian estimates reveal significant and positive relationships between wine drinkers and wages as well as between beverage-unspecific drinkers and wages. We are unable to detect endogeneity problems with the drinking variables, which speaks in favor of OLS regressions. When splitting the sample into age groups, the "wine gain" disappears for employees under the age of 35 and increases in size and significance for higher age groups. We also find a "beer gain" for residents of rural areas and a "cocktail gain" for residents of urban areas. Several explanations for our empirical results are discussed in view of the likelihood that the alcohol-income puzzle is a multicausal phenomenon."alcohol-income puzzle," beverage-specific drinking behavior, wages, wine