Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/216412 
Year of Publication: 
2020
Series/Report no.: 
IZA Discussion Papers No. 13100
Publisher: 
Institute of Labor Economics (IZA), Bonn
Abstract: 
Using a randomized field experiment, we show that health care specialists cream-skim patients by their expected profitability. In the German two-tier system, outpatient reimbursement rates for both public and private insurance are centrally determined but are more than twice as high for the privately insured. In our field experiment, following a standardized protocol, the same hypothetical patient called 991 private practices in 36 German counties to schedule appointments for allergy tests, hearing tests and gastroscopies. Practices were 7% more likely to offer an appointment to the privately insured. Conditional on being offered an appointment, wait times for the publicly insured were twice as long than for the privately insured. Our findings show that structural differences in reimbursement rates lead to structural differences in health care access.
Subjects: 
health care inequality
reimbursement rates
health care access
discrimination
cherry picking
gastroscopy
audiometry
allergy test
allergists
otorhinolaryngologist
gastroenterologist
JEL: 
I14
I11
I18
Document Type: 
Working Paper

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