The deductible in health insurance: do the insured make a choice based on the arguments as intended by the policy makers?

This paper analyzes the decision to accept a deductible or not in the case of health insurance in the Netherlands. A simultaneous model, specifying both the the choice for a deductible and the number of doctor visits, is estimated on Dutch data from 2007. The results indicate that the choice for a deductible does not depend on the health status of individuals and the expected demand for health care in case of having or not having decided for a deductible. As a result, the main argument of the Dutch government for the introduction of a deductible, making people more aware of the health costsm, appears not to be relevant.

Keywords: demand for health care, health insurance, deductibles, count data model, copula estimation technique.