Working Paper: CEPR ID: DP17799
Authors: Jan Boone
Abstract: The rationale for demand side cost sharing in health insurance is to deter patients from using low value care. But if agents are cash constrained, demand side cost sharing can lead them to postpone or forgo valuable treatments. We use data on European (NUTS 2) regions to show that the interaction between poverty rate and out-of-pocket payments leads to unmet medical needs and higher mortality.
Keywords: out-of-pocket payments; mortality; health insurance; poverty; unmet medical needs
JEL Codes: I11; I13; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Higher out-of-pocket payments (OOP) (G52) | Individuals forgoing treatments due to cost (I12) |
| Individuals forgoing treatments due to cost (I12) | Higher mortality rates (I12) |
| High OOP costs + High poverty levels (P46) | Higher mortality rates (I12) |
| Higher OOP payments in regions with high poverty (I32) | Increased mortality (I12) |
| Higher out-of-pocket payments (OOP) (G52) | Increased mortality rates (I12) |