Christian Bünnings

How Health Plan Enrollees Value Prices Relative to Supplemental Benefits and Service Quality

This paper empirically assesses the relative role of health plan prices, service quality and optional benefits in the decision to choose a health plan. We link representative German SOEP panel data from 2007 to 2010 to (i) health plan service quality indicators, (ii) measures of voluntary benefit provision on top of federally mandated benefits, and (iii) health plan prices for almost all German health plans. Mixed logit models incorporate a total of 1,700 health plan choices with more than 50 choice sets for each individual. The findings suggest that, compared to prices, health plan service quality and supplemental benefits play a minor role in making a health plan choice.

Who Opts Out of the Statutory Health Insurance? A Discrete Time Hazard Model for Germany

The coexistence of social health insurance and private health insurance in Germany is subject to intense public debate. As only few have the opportunity to choose between the two systems, they are often regarded as privileged by the health insurance system. Applying a hazard model in discrete time, this paper examines the role of incentives set by the regulatory framework and the influence of individual personality characteristics on the decision to opt out of the statutory system. To address potential endogeneity of one of the key explanatory variables, an instrumental variable approach is also applied. The estimation results yield robust evidence on the choice of health insurance type that is consistent with pragmatic decision making, with both incentives set by regulation and personality traits as relevant determinants. Copyright

Does the Burglar Also Disturb the Neighbor? Crime Spillovers on Individual Well-Being

Indirect psychological effects induced by crime are likely to contribute significantly to the total costs of crime beyond the financial costs of direct victimization. Using detailed crime statistics for the whole of Germany and linking them to individual-level mental health information from the German Socio-Economic Panel, we analyze whether local crime rates affect the mental health of residents. We estimate that a one standard deviation increase in local violent crime rates significantly decreases individual mental well-being among residents by, on average, one percent. Smaller effects are found for property and total crime rates. Results are insensitive to migration and not isolated to urban areas, but are rather driven by less densely populated regions. In contrast to previous literature on vulnerability to crime, we find that men, more educated and singles react more to variation in violent crime rates in their neighborhoods. One potential explanation could be that those who are more fearful of crime have developed better coping strategies and, hence, react less to changes in crime.

Does new health information affect health behaviour? The effect of health events on smoking cessation

ABSTRACT This article empirically assesses the role of new health information in the decision to quit smoking. Using individual level data from the Swiss Household Panel, health information is proxied by three different types of health events: physical health problems, mental disorders, and accidents. Exploiting retrospectively reported information on smoking behaviour, smoking cessation is modelled using a discrete time hazard model that also accounts for estimation problems arising from almost quasi-complete separation in the data. The empirical results yield robust evidence that general health problems increase the probability of instantaneous smoking cessation. Differentiating between the type of health event reveals that the overall effect is mainly driven by physical health events.

The Role of Prices Relative to Supplemental Benefits and Service Quality in Health Plan Choice: The Trade-Off of Health Plan Attributes

This article links representative enrollee panel data to health plan data on (1) prices, (2) service quality, and (3) nonessential benefits for the German statutory multipayer market and the years 2007–2010. We first show that although heavy federal regulation ensures a simple choice architecture, the majority of health plans are dominated—even when considering four nonprice attributes. Enrollees in dominated plans are older, less educated, and unhealthier. Second, we assess how switchers value prices relative to nonprice health plan attributes. Our mixed logit models incorporate a total of 1,700 health plan choices with each more than 50 choice sets. While prices are an important determinant for nearly everyone, 40 percent of all switchers do not seem to value service quality and supplemental benefits when choosing health plans.