Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece

Nikolaos Grigorakis, Christos Floros, Haritini Tsangari, Evangelos Tsoukatos

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The high level of out of pocket (OOP) payments constitutes a major concern for Greece and several other European and OECD countries as a result of the significant down turning of their public health finances due to the 2008 financial crisis. The basic objective of this study is to provide empirical evidence on the effect of combining social health insurance (SHI) and private health insurance (PHI) on OOP payments. Further, this study examines the catastrophic impact of OOP payments on insured’s welfare using the incidence and intensity methodological approach of measuring catastrophic health care expenditures. Conducting a cross-sectional survey in Greece in 2013, we find that the combination of SHI–PHI has a strong negative influence on insured OOP payments for inpatient health care in private hospitals. Furthermore, our results indicate that SHI coverage is not sufficient by itself to manage with this issue. Moreover, we find that poor people present a greater tendency to incur catastrophic OOP expenditures for hospital health care in private providers. Drawing evidence from Greece, a country with huge fiscal problems that has suffered the consequences of the economic crisis more than any other, could be a starting point for policymakers to consider the perspective of SHI–PHI co-operation against OOP payments more seriously.

Original languageEnglish
Pages (from-to)261-287
Number of pages27
JournalInternational Journal of Health Economics and Management
Volume17
Issue number3
DOIs
Publication statusPublished - 2017

Keywords

  • Financial catastrophe
  • Greece
  • Informal payments
  • OOP payments
  • PHI
  • SHI

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