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1、SWISSSOCIALHEALTHINSURANCE:CO-PAYMENTSWORKSTEFANFELDERANDANDREASWERBLOWFromtheperspectiveofaninsurancecommunity,co-paymentsareonlyinterestingiftheyaffecttotalexpenditurebyadecreaseintheprobabilityorthesizeofdamages.Iftheinsuredtakepreventiveactionstoreducetheriskorcha
2、ngetheirbehaviorwhendamagesoccur,theirexpenditurewilldecrease.Ifinsurancecoverageiscomprehensive,importantincentivesforpreventionandrestrictingdamagesareabsent.Economistsspeakofmoralhazard,referringtotheeffectoftheextentofinsurancecoverageonthebehavioroftheinsured.Inh
3、ealthinsurance,theinsuredhaveaparticularlylargeinfluenceontheamountofservicestheydemand.Healthyfood,sufficientphysicalmotion,preventionofstress,allthesereducetheprobabilityofanillness.Moreover,thebehaviorincaseofanillness,i.e.thechoiceoftherapyorthepatients’compliance
4、withthephysicians’prescriptionswillsubstantiallyaffecthealthcareexpenditure.Docopaymentsreducemoralhazardinhealthinsurance?Swisssocialhealthinsuranceisanidealcandidateforstudyingthisissue,asco-paymentshavealongtraditionthere.CharacteristicsoftheSwisshealthinsurancesys
5、temInSwitzerland,100percentofthepopulationisenrolledinthestatutory(basic)healthinsurancesystem.Inthecomplementaryprivateinsurancesector,theequivalenceprincipleholds–theinsuredpayriskequivalentpremiums.Bycomparison,communityratingappliesinsocialhealthinsurance,i.e.ever
6、ypersonwithinasicknessfundpaysthesamepremiumirrespectiveofhis/herrisk.Thisimpliesthattheso-calledgoodrisks(personswhosepaymentsexceedtheirexpectedexpendsubsidizethebadrisks(personswithpaymentsbelowtheexpectedexpenditure).Withthegivenhealthcareexpenditureprofiles,commu
7、nityratingmeansforinstancethattheyoungsubsidizetheoldandthatmensubsidizewomen.IncontrasttoGermanyandothercountries,Switzerlanddoesnotimposeanysubstantialinterregionalredistributioninfinancinghealthcare.Premiumsaredifferentiatedaccordingtoregionaldifferencesinhealthcar
8、eexpenditure.Furthermore,contributionstohealthinsurancearenotpaidfromthepayrollbutfunctionasinotherinsurancesectors.Everyind
