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1、SWISSSOCIALHEALTHINSURANCE:CO-PAYMENTSWORKSTEFANFELDERANDANDREASWERBLOWFromtheperspectiveofaninsurancecommunity,co-paymentsareonlyinterestingiftheyaffecttotalexpenditurebyadecreaseintheprobabilityorthesizeofdamages.Iftheinsuredtakepreventiveactionstoreducetheriskorchangetheir
2、behaviorwhendamagesoccur,theirexpenditurewilldecrease.Ifinsurancecoverageiscomprehensive,importantincentivesforpreventionandrestrictingdamagesareabsent.Economistsspeakofmoralhazard,referringtotheeffectoftheextentofinsurancecoverageonthebehavioroftheinsured.Inhealthinsurance,t
3、heinsuredhaveaparticularlylargeinfluenceontheamountofservicestheydemand.Healthyfood,sufficientphysicalmotion,preventionofstress,allthesereducetheprobabilityofanillness.Moreover,thebehaviorincaseofanillness,i.e.thechoiceoftherapyorthepatients’compliancewiththephysicians’prescr
4、iptionswillsubstantiallyaffecthealthcareexpenditure.Docopaymentsreducemoralhazardinhealthinsurance?Swisssocialhealthinsuranceisanidealcandidateforstudyingthisissue,asco-paymentshavealongtraditionthere.CharacteristicsoftheSwisshealthinsurancesystemInSwitzerland,100percentofthe
5、populationisenrolledinthestatutory(basic)healthinsurancesystem.Inthecomplementaryprivateinsurancesector,theequivalenceprincipleholds–theinsuredpayriskequivalentpremiums.Bycomparison,communityratingappliesinsocialhealthinsurance,i.e.everypersonwithinasicknessfundpaysthesamepre
6、miumirrespectiveofhis/herrisk.Thisimpliesthattheso-calledgoodrisks(personswhosepaymentsexceedtheirexpectedexpendisubsidizethebadrisks(personswithpaymentsbelowtheexpectedexpenditure).Withthegivenhealthcareexpenditureprofiles,communityratingmeansforinstancethattheyoungsubsidize
7、theoldandthatmensubsidizewomen.IncontrasttoGermanyandothercountries,Switzerlanddoesnotimposeanysubstantialinterregionalredistributioninfinancinghealthcare.Premiumsaredifferentiatedaccordingtoregionaldifferencesinhealthcareexpenditure.Furthermore,contributionstohealthinsurance
8、arenotpaidfromthepayrollbutfunctionasinotherinsurancesectors.Everyin
