| Titre : | A new prevention paradox : The trade-off between reducing incentives for risk selection and increasing the incentives for prevention for health insurers. (2013) |
| Auteurs : | Tim-A KANTERS ; Pieter-Hmvan BAAL ; Werner-Bf BROUWER ; POLDER (Johan-J) : NLD. Tranzo Department. Tilburg University. LE Tilburg. ; René-Cjavan VLIET ; Institute of Health Policy & Management. Erasmus University Rotterdam. Rotterdam. NLD |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 76, 2013) |
| Pagination : | 150-158 |
| Langues: | Anglais |
| Mots-clés : | Prévention santé ; Incitation ; Facteur risque ; Risque ; Sélection ; Modèle ; Homme ; Europe ; Maladie chronique ; Assurance privée |
| Résumé : |
[BDSP. Notice produite par INIST-CNRS R0xGktom. Diffusion soumise à autorisation]. The Dutch risk equalization scheme has been improved over the years by including health related risk adjusters. The purpose of the Dutch risk equalization scheme is to prevent risk selection and to correct for predictable losses and gains for insurers. The objective of this paper is to explore the financial incentives for risk selection under the Dutch risk equalization scheme. We used a simulation model to estimate lifetime health care costs and risk equalization contributions for three cohorts (a smoking ; an obese ; and a healthy living cohort). Financial differences for the three cohorts were assessed by subtracting health care costs from risk equalization contributions. Even under an elaborate risk equalization system, the healthy living cohort was still most financially attractive for insurers. Smokers were somewhat less attractive, while the obese cohort was least attractive. Lifetime differences with healthy living individuals (revenues minus costs) were modest : |
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