Abstract
The paper seeks to analyse the evolution of expenditure on private health insurance (PHI) in Spain. We consider the factors that influence PHI demand and level of spending before and during the economic recession, along with identifying the effect of the recession on these factors. The data is obtained from the Spanish Family Budget Survey (SFBS) for 2006 and 2012. Due to the data structure and the demand function, the analysis is performed using a sample selection model in order to avoid sample selection bias. We estimate three models: a pre-recession model (2006), a model for the recession period (2012) and a third one covering both periods (2006 and 2012) and where we include a dummy variable that establishes the effect of the economic recession. The results show that the effect of the economic recession on PHI demand is not significant, but it is on the level of spending.
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Notes
Consolidated public health expenditure fell by 9.11% between 2009 (the year with the highest consolidated public health expenditure) and 2012. This percentage is equivalent to a drop of EUR 6.126 billion (Estadística de Gasto Sanitario Público 2013).
The consolidated public health expenditure increased 26.75% from 2006 to 2009, that is, EUR 1.489 billion (Estadística de Gasto Sanitario Público 2013).
Spanish Family Budget Survey (Encuesta de Presupuestos Familiares) is conducted by the Spanish National Institute of Statistics (Instituto Nacional de Estadística, INE). www.ine.es.
A summary of the variables used and their main descriptive statistics are reported in Table 1 in the appendix.
Health insurance expenditure reported in the survey incorporates school insurance. Assuming that the cheapest health insurance in Spain is around EUR 10 per month, the minimum spending of a household that takes out insurance is EUR 120. Those families that spend less than EUR120 per year are considered as not having contracted health insurance (this expense is assumed to be spending on school insurance).
\( {\text{RECESSION}} \) is introduced only in the third model where all the observation are considered in the 2006 and 2012 model.
The 2PM estimations are also reported in Table 3 in the Appendix.
See Appendix.
There are also workers that are not public sector workers, but they actually represent a lower percentage.
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Acknowledgements
Alaitz Artabe acknowledges financial support from the Spanish Ministerio de Economía y Competitividad (ECO2017-82,111-R) and the Basque Government (IT783-13). Waleska Sigüenza acknowledges financial support from the Spanish Ministerio de Economía y Competitividad (ECO2017-82111-R).
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Artabe, A., Sigüenza, W. The effects of the economic recession on spending on private health insurance in Spain. Int J Health Econ Manag. 19, 155–191 (2019). https://doi.org/10.1007/s10754-018-9251-2
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DOI: https://doi.org/10.1007/s10754-018-9251-2