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

Datos Bibliográficos

ID11680947
AutoresAntonio J Trujillo (0000-0002-0800-8512, University of Central Florida, autor de correspondencia), Dawn C McCalla (University of Central Florida)
Año2004
Volumen23
Número4
Páginas873-888
Fecha de publicación2004-08-25
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaJournal of Policy Analysis and Management (JOURNAL)
Identificadores de la revistaISSN: 0276-8739 • E-ISSN: 1520-6688
EditorialWiley (PUBLISHER • GB)
DOI10.1002/pam.20052
PMID15499708
OpenAlexW1983213360
IdiomaEN
Referencias citadas18

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