December 7, 2017

Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare

Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013.

We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure.

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Foto Minke Remmerswaal
Minke Remmerswaal +31 6 11110450 Lees meer
Foto Jan Boone
Jan Boone +31 88 984 60 00 Lees meer
Foto Michiel Bijlsma
Michiel Bijlsma +31 6 25189723 Lees meer
Foto Rudy Douven
Rudy Douven +31 6 15589095 Lees meer

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