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Article

Постконтрактный оппортунизм на рынке добровольного медицинского страхования

Экономическая политика. 2018. Т. 13. № 3. С. 148-181.

This paper contributes to the discussion on possibilities to reveal ex post moral hazard
in the Russian market for private health insurance. By ‘ex post’ we mean the period
when a health insurance contract is valid. Moral hazard implies risky behavior of a
respondent that increases health care utilization and/or decreases their incentives
to prevent an insured event. In our empirical estimates, we explore the uniqueness
of the Russian data that consists in the fact that many medical organizations provide
services to respondents insured by enterprises. Adverse selection is hardly possible
among such respondents. It gives us the possibility to observe ex post moral hazard,
simply controlling for ex ante moral hazard by the use of individual fixed effects in
panel data models. We use the RLMS-HSE data (2000–2015) for empirical estimates.
We consider doctor visits, tobacco and alcohol consumption, physical exercises, and
self-assessed health (SAH) as moral hazard indicators, estimating ordered choice
regression models for each of the dependent variables mentioned above. To avoid
inconsistency in estimates of parameters caused by the incidental parameter problem,
we use the Blow-Up and Cluster (BUC) estimator. The results show a statistically
significant increase in frequency of visits to the doctor and in alcohol consumption,
as well as a decrease in SAH during the period of insurance. These results could be
useful for insurance companies and could be accounted for in contracts for private
health insurance.