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    Should I stay or should I go? Exit options within mixed systems of public and private health care finance

    250424.pdf (291.1Kb)
    Access Status
    Open access
    Authors
    Buckley, N.
    Cuff, K.
    Hurley, J.
    Mestelman, S.
    Thomas, Stephanie
    Cameron, D.
    Date
    2016
    Type
    Journal Article
    
    Metadata
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    Citation
    Buckley, N. and Cuff, K. and Hurley, J. and Mestelman, S. and Thomas, S. and Cameron, D. 2016. Should I stay or should I go? Exit options within mixed systems of public and private health care finance. Journal of Economic Behavior & Organization. 131 (Part B): pp. 62-77.
    Source Title
    Journal of Economic Behavior & Organization
    DOI
    10.1016/j.jebo.2016.05.013
    ISSN
    0167-2681
    School
    School of Economics and Finance
    URI
    http://hdl.handle.net/20.500.11937/50766
    Collection
    • Curtin Research Publications
    Abstract

    Mixed public–private finance is widespread in health care systems internationally. In one variant of mixed finance, some countries (e.g., Germany) allow eligible beneficiaries to fully exit from the public (social insurance) system and purchase private insurance. Using a controlled laboratory experiment, we empirically investigate the predictions of a political economy model of mixed systems of public and private finance with two types of exit: universal-exit, when all individuals can choose to exit the public system, and conditional-exit, when only individuals with an income at or above a threshold income level can choose to exit. We find that high-income individuals are less likely to exit under universal-exit than under conditional-exit, despite having the same incentive to exit in both treatments. Sensitivity treatments suggests that a number of factors may be at play in explaining this result, including learning effects, a priming effect and a framing effect, but that other-regarding preferences do not appear to be an important factor.

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