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Moral hazard in health care: case study of Taiwan's national health insurance

dc.contributor.authorLin, Chun-Wei, author
dc.contributor.authorFan, Chuen-Mei, advisor
dc.contributor.authorMushinski, David, committee member
dc.contributor.authorPena, Anita Alves, committee member
dc.contributor.authorLoomis, John B., committee member
dc.date.accessioned2007-01-03T08:09:53Z
dc.date.available2007-01-03T08:09:53Z
dc.date.issued2012
dc.description.abstractMy research examines the moral hazard phenomenon under Taiwan's National Health Insurance system theoretically as well as empirically. The objective is to investigate the effects of universal health insurance on individual lifestyle behavior such as smoking and alcohol consumption. In the analytical section, I incorporate the individual's copayment rate, the premium, and the payroll tax rate in a moral-hazard model of national health care insurance plan. The two-stage for individual decision is applied to an extension of the moral hazard model originally proposed by Ehrlich and Becker (1972) and Stanciole (2007). In stage one, an individual moves first and decides his / her optimal unhealthy behavior before knowing the health status. In stage two, once the health status is revealed, he/she will move to choose the optimal amount of medical care after stage one. By applying the backward induction method, I show that after individuals falling sick in stage two, the optimal demand for medical service decreases when faced with a higher payroll tax rate, a higher copayment rate, a higher premium, and a higher medical service price. However, an individual's optimal demand for medical service increases with the individual's income level, poor health status and with the addiction of unhealthy behavior. In stage one, the individual's optimal unhealthy behaviors decrease with a higher copayment rate, a higher payroll tax rate, a higher premium, a higher medical price and with poor health status; but increase with income level. The effect from medical service is ambiguous. I also examine how three government policy parameters -copayment rate, premium, and payroll tax rate - affect individual's welfare given his/her lifestyle under the universal health insurance system. My model results suggest that the copayment rate has an ambiguous effect on individual's well-being. Payroll tax rate and Premium have positive effects on the individual's well-being. In my empirical investigation, I use two waves of the Health and Living Status of the Middle- Age and Elderly (SHLS) survey in Taiwan (1993 and 2007). Lifestyle behaviors (smoking and alcohol consumption) are employed as dependent variables. In my econometric model, I use a univariate Probit model and a seemingly unrelated bivariate Probit model to measure the determinants of unhealthy lifestyle behavior in 1993 and 2007. Two lifestyle behaviors - smoking and alcohol consumption - are employed as dependent variables in my model. Lastly, I apply a difference-in-difference (DD) methodology to compare how these effects change before and after implementation of Taiwan's national health insurance system. The result shows a lack of evidence in my data for the effect of national health insurance, implying no moral hazard effect is found under Taiwan's National Health Insurance.
dc.format.mediumborn digital
dc.format.mediumdoctoral dissertations
dc.identifierLin_colostate_0053A_11031.pdf
dc.identifierETDF2012400252ECON
dc.identifier.urihttp://hdl.handle.net/10217/67467
dc.languageEnglish
dc.language.isoeng
dc.publisherColorado State University. Libraries
dc.relation.ispartof2000-2019
dc.rightsCopyright and other restrictions may apply. User is responsible for compliance with all applicable laws. For information about copyright law, please see https://libguides.colostate.edu/copyright.
dc.subjectlifestyle behavior
dc.subjectnational health insurance
dc.subjectmoral hazard
dc.titleMoral hazard in health care: case study of Taiwan's national health insurance
dc.typeText
dcterms.rights.dplaThis Item is protected by copyright and/or related rights (https://rightsstatements.org/vocab/InC/1.0/). You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).
thesis.degree.disciplineEconomics
thesis.degree.grantorColorado State University
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Philosophy (Ph.D.)

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