[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
IDEAS home Printed from https://ideas.repec.org/p/pra/mprapa/115727.html
   My bibliography  Save this paper

Accuracy of self-reported private health insurance coverage

Author

Listed:
  • Nguyen, Ha Trong
  • Le, Huong Thu
  • Connelly, Luke B.
  • Mitrou, Francis
Abstract
Studies on health insurance coverage often rely on measures self-reported by respondents, but the accuracy of such measures has not been thoroughly validated. This paper is the first to use linked Australian National Health Survey and administrative population tax data to explore the accuracy of self-reported private health insurance (PHI) coverage in survey data. We find that 9% of individuals misreport their PHI coverage status, with 5% of true PHI holders reporting that they are uninsured and 16% of true non-insured persons self-identifying as insured. Our results show reporting errors are systematically correlated with individual and household characteristics. Our evidence on the determinants of errors is supportive of common reasons for misreporting. We directly investigate biases in the determinants of PHI enrolment using survey data. We find that, as compared to administrative data, survey data depict a quantitatively different picture of PHI enrolment determinants, especially those capturing age, language proficiency, labour force status or the number of children. We also show that PHI coverage misreporting is subsequently associated with misreporting of reasons for purchasing PHI, type of cover and length of cover.

Suggested Citation

  • Nguyen, Ha Trong & Le, Huong Thu & Connelly, Luke B. & Mitrou, Francis, 2022. "Accuracy of self-reported private health insurance coverage," MPRA Paper 115727, University Library of Munich, Germany.
  • Handle: RePEc:pra:mprapa:115727
    as

    Download full text from publisher

    File URL: https://mpra.ub.uni-muenchen.de/115727/1/MPRA_paper_115727.pdf
    File Function: original version
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Brent Kreider, 2010. "Regression Coefficient Identification Decay in The Presence of Infrequent Classification Errors," The Review of Economics and Statistics, MIT Press, vol. 92(4), pages 1017-1023, November.
    2. Nathan Kettlewell & Olena Stavrunova & Oleg Yerokhin, 2018. "Premium subsidies and demand for private health insurance: results from a regression discontinuity design," Applied Economics Letters, Taylor & Francis Journals, vol. 25(2), pages 96-101, January.
    3. Bruce D. Meyer & Nikolas Mittag, 2019. "Using Linked Survey and Administrative Data to Better Measure Income: Implications for Poverty, Program Effectiveness, and Holes in the Safety Net," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 176-204, April.
    4. Cawley, John & Maclean, Johanna Catherine & Hammer, Mette & Wintfeld, Neil, 2015. "Reporting error in weight and its implications for bias in economic models," Economics & Human Biology, Elsevier, vol. 19(C), pages 27-44.
    5. Michael Baker & Mark Stabile & Catherine Deri, 2004. "What Do Self-Reported, Objective, Measures of Health Measure?," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
    6. Nathan Kettlewell & Yuting Zhang, 2024. "Age penalties and take‐up of private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 636-651, April.
    7. Kettlewell, Nathan, 2019. "Risk preference dynamics around life events," Journal of Economic Behavior & Organization, Elsevier, vol. 162(C), pages 66-84.
    8. Battistin, Erich & De Nadai, Michele & Sianesi, Barbara, 2014. "Misreported schooling, multiple measures and returns to educational qualifications," Journal of Econometrics, Elsevier, vol. 181(2), pages 136-150.
    9. Savage, Elizabeth & Wright, Donald J., 2003. "Moral hazard and adverse selection in Australian private hospitals: 1989-1990," Journal of Health Economics, Elsevier, vol. 22(3), pages 331-359, May.
    10. Shuaizhang Feng & Yingyao Hu, 2013. "Misclassification Errors and the Underestimation of the US Unemployment Rate," American Economic Review, American Economic Association, vol. 103(2), pages 1054-1070, April.
    11. R. Bollinger, Christopher & Valentinova Tasseva, Iva, 2022. "Income source confusion using the SILC," ISER Working Paper Series 2022-04, Institute for Social and Economic Research.
    12. Johnston, David W. & Propper, Carol & Shields, Michael A., 2009. "Comparing subjective and objective measures of health: Evidence from hypertension for the income/health gradient," Journal of Health Economics, Elsevier, vol. 28(3), pages 540-552, May.
    13. Erik Hurst & Geng Li & Benjamin Pugsley, 2014. "Are Household Surveys Like Tax Forms? Evidence from Income Underreporting of the Self-Employed," The Review of Economics and Statistics, MIT Press, vol. 96(1), pages 19-33, March.
    14. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2011. "Waiting times for elective surgery and the decision to buy private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 68-86, September.
    15. Paul Bingley & Alessandro Martinello, 2017. "Measurement Error in Income and Schooling and the Bias of Linear Estimators," Journal of Labor Economics, University of Chicago Press, vol. 35(4), pages 1117-1148.
    16. Doiron, Denise & Fiebig, Denzil G. & Suziedelyte, Agne, 2014. "Hips and hearts: The variation in incentive effects of insurance across hospital procedures," Journal of Health Economics, Elsevier, vol. 37(C), pages 81-97.
    17. Bruce D. Meyer & Wallace K. C. Mok & James X. Sullivan, 2009. "The Under-Reporting of Transfers in Household Surveys: Its Nature and Consequences," NBER Working Papers 15181, National Bureau of Economic Research, Inc.
    18. Hausman, J. A. & Abrevaya, Jason & Scott-Morton, F. M., 1998. "Misclassification of the dependent variable in a discrete-response setting," Journal of Econometrics, Elsevier, vol. 87(2), pages 239-269, September.
    19. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    20. Gary Solon & Steven J. Haider & Jeffrey M. Wooldridge, 2015. "What Are We Weighting For?," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 301-316.
    21. Damien S. Eldridge & Ilke Onur & Malathi Velamuri, 2017. "The impact of private hospital insurance on the utilization of hospital care in Australia," Applied Economics, Taylor & Francis Journals, vol. 49(1), pages 78-95, January.
    22. Anam Bilgrami & Henry Cutler & Kompal Sinha & Zhiming Cheng, 2021. "The Impact of Means‐Tested Premium Rebates and Tax Penalties on the Demand for Private Hospital Cover in Australia," The Economic Record, The Economic Society of Australia, vol. 97(317), pages 170-211, June.
    23. Nelson, D.E. & Thompson, B.L. & Davenport, N.J. & Penaloza, L.J., 2000. "What people really know about their health insurance: A comparison of information obtained from individuals and their insurers," American Journal of Public Health, American Public Health Association, vol. 90(6), pages 924-928.
    24. Celhay, Pablo & Meyer, Bruce D. & Mittag, Nikolas, 2022. "What Leads to Measurement Errors? Evidence from Reports of Program Participation in Three Surveys," IZA Discussion Papers 14995, Institute of Labor Economics (IZA).
    25. Preety Srivastava & Gang Chen & Anthony Harris, 2017. "Oral Health, Dental Insurance and Dental Service use in Australia," Health Economics, John Wiley & Sons, Ltd., vol. 26(1), pages 35-53, January.
    26. Bruce D. Meyer & Nikolas Mittag, 2019. "Misreporting of Government Transfers: How Important Are Survey Design and Geography?," Southern Economic Journal, John Wiley & Sons, vol. 86(1), pages 230-253, July.
    27. Trong-Ha Nguyen & Suiwah Leung, 2013. "Dynamics of health insurance enrollment in Vietnam, 2004–2006," Journal of the Asia Pacific Economy, Taylor & Francis Journals, vol. 18(4), pages 594-614.
    28. Drake, Coleman & Ryan, Conor & Dowd, Bryan, 2022. "Sources of inertia in the individual health insurance market," Journal of Public Economics, Elsevier, vol. 208(C).
    29. Patrick Hullegie & Tobias J. Klein, 2010. "The effect of private health insurance on medical care utilization and self‐assessed health in Germany," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1048-1062, September.
    30. Stavrunova, Olena & Yerokhin, Oleg, 2014. "Tax incentives and the demand for private health insurance," Journal of Health Economics, Elsevier, vol. 34(C), pages 121-130.
    31. Propper, Carol & Rees, Hedley & Green, Katherine, 2001. "The Demand for Private Medical Insurance in the UK: A Cohort Analysis," Economic Journal, Royal Economic Society, vol. 111(471), pages 180-200, May.
    32. Connelly, Luke B. & Paolucci, Francesco & Butler, James R.G. & Collins, Paul, 2010. "Risk equalisation and voluntary health insurance markets: The case of Australia," Health Policy, Elsevier, vol. 98(1), pages 3-14, November.
    33. Arie Kapteyn & Jelmer Y. Ypma, 2007. "Measurement Error and Misclassification: A Comparison of Survey and Administrative Data," Journal of Labor Economics, University of Chicago Press, vol. 25(3), pages 513-551.
    34. Burkhauser, Richard V. & Cawley, John, 2008. "Beyond BMI: The value of more accurate measures of fatness and obesity in social science research," Journal of Health Economics, Elsevier, vol. 27(2), pages 519-529, March.
    35. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    36. Alfons Palangkaraya & Jongsay Yong, 2005. "Effects of Recent Carrot‐and‐Stick Policy Initiatives on Private Health Insurance Coverage in Australia," The Economic Record, The Economic Society of Australia, vol. 81(254), pages 262-272, September.
    37. Bollinger, Christopher R & David, Martin H, 2001. "Estimation with Response Error and Nonresponse: Food-Stamp Participation in the SIPP," Journal of Business & Economic Statistics, American Statistical Association, vol. 19(2), pages 129-141, April.
    38. Ha Trong Nguyen & Huong Thu Le & Luke B Connelly, 2021. "Who's declining the “free lunch”? New evidence from the uptake of public child dental benefits," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 270-288, February.
    39. Nathan Kettlewell, 2019. "Utilization and Selection in an Ancillaries Health Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(4), pages 989-1017, December.
    40. Jenkins, Stephen P. & Rios-Avila, Fernando, 2021. "Reconciling Reports: Modelling Employment Earnings and Measurement Errors Using Linked Survey and Administrative Data," IZA Discussion Papers 14405, Institute of Labor Economics (IZA).
    41. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    42. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    43. Bruce D. Meyer & Wallace K. C. Mok & James X. Sullivan, 2015. "Household Surveys in Crisis," Journal of Economic Perspectives, American Economic Association, vol. 29(4), pages 199-226, Fall.
    44. John M. Abowd & Martha H. Stinson, 2013. "Estimating Measurement Error in Annual Job Earnings: A Comparison of Survey and Administrative Data," The Review of Economics and Statistics, MIT Press, vol. 95(5), pages 1451-1467, December.
    45. Sandra Hopkins & Michael P. Kidd & Aydogan Ulker, 2013. "Private Health Insurance Status and Utilisation of Dental Services in Australia," The Economic Record, The Economic Society of Australia, vol. 89(285), pages 194-206, June.
    46. Buchmueller, Thomas C. & Cheng, Terence C. & Pham, Ngoc T.A. & Staub, Kevin E., 2021. "The effect of income-based mandates on the demand for private hospital insurance and its dynamics," Journal of Health Economics, Elsevier, vol. 75(C).
    47. Bound, John & Brown, Charles & Mathiowetz, Nancy, 2001. "Measurement error in survey data," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 59, pages 3705-3843, Elsevier.
    48. Randall Ellis & Elizabeth Savage, 2008. "Run for cover now or later? The impact of premiums, threats and deadlines on private health insurance in Australia," International Journal of Health Economics and Management, Springer, vol. 8(4), pages 257-277, December.
    49. Meyer, Bruce D. & Mittag, Nikolas, 2017. "Misclassification in binary choice models," Journal of Econometrics, Elsevier, vol. 200(2), pages 295-311.
    50. Denise Doiron & Nathan Kettlewell, 2020. "Family formation and the demand for health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 523-533, April.
    51. Cameron, A. Colin & Trivedi, Pravin K., 1991. "The role of income and health risk in the choice of health insurance : Evidence from Australia," Journal of Public Economics, Elsevier, vol. 45(1), pages 1-28, June.
    52. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334, March.
    53. Buchmueller, Thomas C. & Fiebig, Denzil G. & Jones, Glenn & Savage, Elizabeth, 2013. "Preference heterogeneity and selection in private health insurance: The case of Australia," Journal of Health Economics, Elsevier, vol. 32(5), pages 757-767.
    54. Denise Doiron & Nathan Kettlewell, 2018. "The Effect of Health Insurance on the Substitution between Public and Private Hospital Care," The Economic Record, The Economic Society of Australia, vol. 94(305), pages 135-154, June.
    55. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    56. Nikolas Mittag, 2019. "Correcting for Misreporting of Government Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 11(2), pages 142-164, May.
    57. Johar, Meliyanni & Savage, Elizabeth, 2012. "Sources of advantageous selection: Evidence using actual health expenditure risk," Economics Letters, Elsevier, vol. 116(3), pages 579-582.
    58. Ithai Z. Lurie & James Pearce, 2021. "Health Insurance Coverage in Tax and Survey Data," American Journal of Health Economics, University of Chicago Press, vol. 7(2), pages 164-184.
    59. Randall P. Ellis & Elizabeth Savage, 2008. "Run for Cover Now or Later? The impact of premiums, threats and deadlines on supplementary private health insurance in Australia," Boston University - Department of Economics - Working Papers Series wp2008-013, Boston University - Department of Economics.
    60. Francesca Colombo & Nicole Tapay, 2004. "Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems," OECD Health Working Papers 15, OECD Publishing.
    61. Cheng, Terence Chai, 2014. "Measuring the effects of reducing subsidies for private insurance on public expenditure for health care," Journal of Health Economics, Elsevier, vol. 33(C), pages 159-179.
    62. Bruce D. Meyer & Nikolas Mittag & Robert M. Goerge, 2022. "Errors in Survey Reporting and Imputation and Their Effects on Estimates of Food Stamp Program Participation," Journal of Human Resources, University of Wisconsin Press, vol. 57(5), pages 1605-1644.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Judith Liu & Yuting Zhang, 2023. "Elderly responses to private health insurance incentives: Evidence from Australia," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2730-2744, December.
    2. Denise Doiron & Nathan Kettlewell, 2018. "The Effect of Health Insurance on the Substitution between Public and Private Hospital Care," The Economic Record, The Economic Society of Australia, vol. 94(305), pages 135-154, June.
    3. Denise Doiron & Nathan Kettlewell, 2020. "Family formation and the demand for health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 523-533, April.
    4. Kettlewell, Nathan & Zhang, Yuting, 2024. "Financial incentives and private health insurance demand on the extensive and intensive margins," Journal of Health Economics, Elsevier, vol. 94(C).
    5. Nathan Kettlewell & Yuting Zhang, 2024. "Age penalties and take‐up of private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 636-651, April.
    6. Nathan Kettlewell, 2019. "Utilization and Selection in an Ancillaries Health Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(4), pages 989-1017, December.
    7. Buchmueller, Thomas C. & Cheng, Terence C. & Pham, Ngoc T.A. & Staub, Kevin E., 2021. "The effect of income-based mandates on the demand for private hospital insurance and its dynamics," Journal of Health Economics, Elsevier, vol. 75(C).
    8. Kettlewell, Nathan & Zhang, Yuting, 2023. "Financial Incentives and Private Health Insurance Demand on the Extensive and Intensive Margins," IZA Discussion Papers 16248, Institute of Labor Economics (IZA).
    9. Kettlewell, Nathan, 2020. "Subjective Expectations for Health Service Use and Consequences for Health Insurance Behavior," IZA Discussion Papers 13445, Institute of Labor Economics (IZA).
    10. Lan Nguyen & Andrew C. Worthington, 2023. "Moral hazard in Australian private health insurance: the case of dental care services and extras cover," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 157-176, January.
    11. Nathan Kettlewell, 2020. "Policy Choice and Product Bundling in a Complicated Health Insurance Market: Do People Get It Right?," Journal of Human Resources, University of Wisconsin Press, vol. 55(2), pages 566-610.
    12. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.
    13. Kiil, Astrid, 2012. "What characterises the privately insured in universal health care systems? A review of the empirical evidence," Health Policy, Elsevier, vol. 106(1), pages 60-75.
    14. Celhay, Pablo & Meyer, Bruce D. & Mittag, Nikolas, 2024. "What leads to measurement errors? Evidence from reports of program participation in three surveys," Journal of Econometrics, Elsevier, vol. 238(2).
    15. Adam Bee & Joshua Mitchell & Nikolas Mittag & Jonathan Rothbaum & Carl Sanders & Lawrence Schmidt & Matthew Unrath, 2023. "National Experimental Wellbeing Statistics - Version 1," Working Papers 23-04, Center for Economic Studies, U.S. Census Bureau.
    16. Nguyen, John, 2023. "The impact of private health insurance on household savings : Evidence from Australia," Warwick-Monash Economics Student Papers 48, Warwick Monash Economics Student Papers.
    17. Cheng, Terence Chai, 2014. "Measuring the effects of reducing subsidies for private insurance on public expenditure for health care," Journal of Health Economics, Elsevier, vol. 33(C), pages 159-179.
    18. Damien S. Eldridge & Ilke Onur & Malathi Velamuri, 2017. "The impact of private hospital insurance on the utilization of hospital care in Australia," Applied Economics, Taylor & Francis Journals, vol. 49(1), pages 78-95, January.
    19. Michele Lalla & Maddalena Cavicchioli, 2020. "Nonresponse and measurement errors in income: matching individual survey data with administrative tax data," Department of Economics 0170, University of Modena and Reggio E., Faculty of Economics "Marco Biagi".
    20. Christian vom Lehn & Cache Ellsworth & Zachary Kroff, 2022. "Reconciling Occupational Mobility in the Current Population Survey," Journal of Labor Economics, University of Chicago Press, vol. 40(4), pages 1005-1051.

    More about this item

    Keywords

    Health Insurance; Measurement Error; Administrative Data; Survey Misreporting; Linked Data; Australia;
    All these keywords.

    JEL classification:

    • C8 - Mathematical and Quantitative Methods - - Data Collection and Data Estimation Methodology; Computer Programs
    • C81 - Mathematical and Quantitative Methods - - Data Collection and Data Estimation Methodology; Computer Programs - - - Methodology for Collecting, Estimating, and Organizing Microeconomic Data; Data Access
    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pra:mprapa:115727. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Joachim Winter (email available below). General contact details of provider: https://edirc.repec.org/data/vfmunde.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.