Are Colombian sickness funds cream skimming enrollees? An analysis with suggestions for policy improvement

Bibliographic Data

ID11680947
AuthorsAntonio J Trujillo (0000-0002-0800-8512, University of Central Florida, corresponding author), Dawn C McCalla (University of Central Florida)
Year2004
Volume23
Issue4
Pages873-888
Publication date2004-08-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Policy Analysis and Management (JOURNAL)
Journal identifiersISSN: 0276-8739 • E-ISSN: 1520-6688
PublisherWiley (PUBLISHER • GB)
DOI10.1002/pam.20052
PMID15499708
OpenAlexW1983213360
LanguageEN
References cited18

One of the primary objectives of Colombian social health insurance reform was to increase competition among for-profit insurers. Unfortunately, the flat capitated formula creates an opportunity for sickness funds to maximize reimbursement gains by cream skimming--selecting against unhealthy individuals. This paper explores sickness fund selection behavior to evaluate the efficiency losses associated with the introduction of managed competition in Colombia. Data from a 1997 Colombian household survey are analyzed with a bivariate probit model with partial observability using instrumental variables. The model yields some evidence of sickness fund selection based on health status. Public policy options to discourage risk selection by health status are discussed

Actuarial science · Bivariate analysis · Business · Competition (biology · Econometrics · Economic growth · Economics · Health care · Multivariate probit model · Probit model · Public economics · Public fund · Reimbursement · Global Health Care Issues · Healthcare Policy and Management · Healthcare Systems and Reforms