Related Experiment Video
Updated: Jul 15, 2026

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
Does risk equalization reduce the viability of voluntary deductibles?
R C van Kleef1, K Beck, W P M M van de Ven
1Institute of Health Policy and Management iBMG, Erasmus University Rotterdam, Rotterdam, The Netherlands. r.vankleef@erasmusmc.nl
Abstract:
Theoretically, a risk avers consumer takes a deductible if the premium rebate (far) exceeds his/her expected out-of-pocket expenditures. In the absence of risk equalization, insurers are able to offer high rebates because those who select into a deductible plan have below-average expenses. This paper shows that, for high deductibles, such rebates cannot be offered if risk equalization would "perfectly" adjust for the effect of self selection. Since the main goal of user charges is to reduce moral hazard, some effect of self selection on the premium rebate can be justified to increase the viability of voluntary deductibles.
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