Demand for Health & Healthcare - Price & Income elasticities of healthcare demand - Two important randomized experiments

5 important questions on Demand for Health & Healthcare - Price & Income elasticities of healthcare demand - Two important randomized experiments

What were two important randomized experiments?

  1. The RAND Health insurance experiment (1971 - 1982)
  2. Oregon Health insurance experiment (2008)

How was the RAND experiment designed?

  • 7.700 selected individuals (<65 years of age; 6 regions).
  • Randomly assigned to 4 cost-sharing levels: 0.25, 0.50, 0.75 & 0.95%
  • Income dependent limit on out-of-pocket expenses (up to $1.000,-). (NB resulting in nonlinear coverage!)

What were the main findings from the RAND experiment about price elasticities?

  • Mean price eslasticities -0.2
  • Price elasticities vary across health services
  • Reduction of care primarily due to less initiation of care (once they're in the price effect is smaller)
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How was the Oregon experiment designed?

  • Natural experiment: lottery for low-income uninsured to get Medicaid insurance.
  • Price variations between a randomly selected treatment group and a control group.

What were the main findings from the Oregon experiment about price elasticities?

  • Treatment group selected by the lottery had substantively and statistically significantly higher healthcare utilization (including primary and preventive care as well as hospital care).
  • Estimates seem slightly smaller than those found in RAND.

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