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Related Concept Videos

Relative Risk01:12

Relative Risk

Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
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Strategies for Assessing and Addressing Confounding

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Hazard Ratio01:12

Hazard Ratio

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Equity Theory01:26

Equity Theory

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Related Experiment Video

Updated: Jul 8, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

Risk equalization and voluntary deductibles: a complex interaction.

R C van Kleef1, K Beck, W P M M van de Ven

  • 1Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands. vankleef@bmg.eur.nl

Journal of Health Economics
|January 8, 2008
PubMed
Summary
This summary is machine-generated.

Voluntary deductibles in Swiss and Dutch health insurance impact risk equalization. Current systems may incentivize "cream skimming" and reduce cross-subsidies, potentially disadvantaging sicker individuals.

Related Experiment Videos

Last Updated: Jul 8, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

Area of Science:

  • Health Economics
  • Insurance Systems
  • Public Policy

Background:

  • Mandatory health insurance systems in Switzerland and the Netherlands incorporate voluntary deductibles.
  • Risk equalization systems are crucial for ensuring financial stability and equity in these insurance markets.
  • The design of risk equalization directly influences insurer behavior and market outcomes.

Purpose of the Study:

  • To analyze the implications of voluntary deductibles on health insurance risk equalization systems.
  • To theoretically and empirically assess the effects of different expenditure equalization methods.
  • To investigate the impact of deductibles on insurer incentives, self-selection, and cross-subsidies.

Main Methods:

  • Theoretical analysis of expenditure equalization strategies (net claims, out-of-pocket, moral hazard).
  • Empirical examination of self-selection effects related to voluntary deductibles.
  • Comparative analysis of Swiss and Dutch risk equalization systems.

Main Results:

  • Equalizing only net claims, as in Switzerland, incentivizes 'cream skimming' and limits premium adjustments for out-of-pocket costs and moral hazard.
  • Empirical analysis indicates that risk equalization systems do not fully account for health status differences between those selecting deductibles and those who do not.
  • Voluntary deductibles can lead to reduced cross-subsidies from healthier to less healthy individuals.

Conclusions:

  • The current risk equalization frameworks in Switzerland and the Netherlands may not adequately address the consequences of voluntary deductibles.
  • Incentives for 'cream skimming' persist, potentially undermining the equity goals of mandatory health insurance.
  • Policy adjustments may be needed to ensure fairer risk distribution and cross-subsidization in the presence of voluntary deductibles.