Managed competition in practice: Lessons for healthcare policy

Research output: ThesisDoctoral ThesisScientific

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Abstract

This dissertation contributes to a better understanding of the health insurance markets in managed competition setting by discussing potential market failures and policy interventions. After the introduction of Chapter 1, Chapter 2 measures price elasticity in the Netherlands before and after the health insurance reforms in 2006. Chapter 3 provides evidence for adverse selection in the Dutch health insurance market due to voluntary deductibles. Chapter 4 illustrates the welfare effects of increased degree of substitution in the health insurance market using a theoretical model. Chapter 5 explores the incentives for and welfare effects of vertical integration and exclusive behavior between health insurers and hospitals in a theoretical model. Finally, Chapter 6 studies the effect of financing the healthcare expenditures through insurance (rather than directly out of packet) on the hospital merger analyses. The empirical studies (Chapter 2 and 3) use data from the Netherlands. Nonetheless, the main conclusions and the theoretical models (Chapter 4, 5 and 6) can also be applied to other health care systems based on the principles of managed competition.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Tilburg University
Supervisors/Advisors
  • Boone, Jan, Promotor
  • Argenton, Cedric, Co-promotor
Award date14 May 2019
Place of PublicationTilburg
Publisher
Print ISBNs978 90 5668 586 7
Publication statusPublished - 2019

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Health insurance
Health care policy
Managed competition
Insurance market
Welfare effects
The Netherlands
Adverse selection
Policy intervention
Vertical integration
Financing
Market failure
Healthcare
Empirical study
Substitution
Price elasticity
Insurer
Incentives
Insurance
Deductibles
Expenditure

Cite this

Katona, K. (2019). Managed competition in practice: Lessons for healthcare policy. Tilburg: CentER, Center for Economic Research.
Katona, Katalin. / Managed competition in practice : Lessons for healthcare policy. Tilburg : CentER, Center for Economic Research, 2019. 193 p.
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author = "Katalin Katona",
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Katona, K 2019, 'Managed competition in practice: Lessons for healthcare policy', Doctor of Philosophy, Tilburg University, Tilburg.

Managed competition in practice : Lessons for healthcare policy. / Katona, Katalin.

Tilburg : CentER, Center for Economic Research, 2019. 193 p.

Research output: ThesisDoctoral ThesisScientific

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N2 - This dissertation contributes to a better understanding of the health insurance markets in managed competition setting by discussing potential market failures and policy interventions. After the introduction of Chapter 1, Chapter 2 measures price elasticity in the Netherlands before and after the health insurance reforms in 2006. Chapter 3 provides evidence for adverse selection in the Dutch health insurance market due to voluntary deductibles. Chapter 4 illustrates the welfare effects of increased degree of substitution in the health insurance market using a theoretical model. Chapter 5 explores the incentives for and welfare effects of vertical integration and exclusive behavior between health insurers and hospitals in a theoretical model. Finally, Chapter 6 studies the effect of financing the healthcare expenditures through insurance (rather than directly out of packet) on the hospital merger analyses. The empirical studies (Chapter 2 and 3) use data from the Netherlands. Nonetheless, the main conclusions and the theoretical models (Chapter 4, 5 and 6) can also be applied to other health care systems based on the principles of managed competition.

AB - This dissertation contributes to a better understanding of the health insurance markets in managed competition setting by discussing potential market failures and policy interventions. After the introduction of Chapter 1, Chapter 2 measures price elasticity in the Netherlands before and after the health insurance reforms in 2006. Chapter 3 provides evidence for adverse selection in the Dutch health insurance market due to voluntary deductibles. Chapter 4 illustrates the welfare effects of increased degree of substitution in the health insurance market using a theoretical model. Chapter 5 explores the incentives for and welfare effects of vertical integration and exclusive behavior between health insurers and hospitals in a theoretical model. Finally, Chapter 6 studies the effect of financing the healthcare expenditures through insurance (rather than directly out of packet) on the hospital merger analyses. The empirical studies (Chapter 2 and 3) use data from the Netherlands. Nonetheless, the main conclusions and the theoretical models (Chapter 4, 5 and 6) can also be applied to other health care systems based on the principles of managed competition.

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Katona K. Managed competition in practice: Lessons for healthcare policy. Tilburg: CentER, Center for Economic Research, 2019. 193 p.