Working Paper: CEPR ID: DP3021
Authors: Rainer Winkelmann
Abstract: The Paper evaluates the German health care reform of 1997, using the individual number of doctor visits as outcome measure. A new econometric model, the Probit-Poisson-log-normal model with correlated errors, describes the data better than existing count data models. Moreover, it has an attractive structural interpretation, as it allows the reforms to have a different effect at different parts of the distribution. The overall effect of the reform was a 10% reduction in the number of doctor visits. The effect was much larger in the lower part of the distribution than in the upper part.
Keywords: Copayment; Count Data; Moral Hazard; Probit-Poisson-Lognormal Model
JEL Codes: C25; I11; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| 1997 German health care reform (I18) | reduction in doctor visits (I11) |
| increased copayments (I13) | reduction in doctor visits (I11) |
| 1997 German health care reform (I18) | probability of having at least one doctor visit decreases (I14) |
| 1997 German health care reform (I18) | expected number of doctor visits conditional on at least one visit decreases (I14) |
| 1997 German health care reform (I18) | strong impact among less frequent users of health services (I11) |