Cream Skimming by Health Care Providers and Inequality in Health Care Access: Evidence from a Randomized Field Experiment

Abstract

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Testing for Ethnic Discrimination in Outpatient Health Care Evidence from a Field Experiment in Germany

“…In line with our results, the authors find that patients with PHI are more likely to be offered an appointment (plus 4%), and have to wait less (minus 100%). Quantitatively, Werbeck et al (2021) find (as compared to our results) smaller effects of PHI on appointment rates, but a stronger effect on wait times conditional on being offered an appointment. A potential explanation for this differential finding is the specific choice of specialists and requested treatments.…”

“…There is the familiar tale of separate waiting rooms in a physician's office, with shorter waiting times for privately insured patients. However, the evidence is mixed at best, and research designs are often not strong enough to causally identify the impact of insurance (see Werbeck et al (2021) for a discussion on this point).…”

“…Our results confirm and expand existing evidence. Most closely related is the field experiment by Werbeck et al (2021), in which fictitious patients with SHI versus PHI contacted 991 private practices in 36 German counties to schedule appointments for allergy tests, hearing tests and gastroscopies. In line with our results, the authors find that patients with PHI are more likely to be offered an appointment (plus 4%), and have to wait less (minus 100%).…”

Long-Term Health Insurance: Theory Meets Evidence

“…As a consequence, wait times in the outpatient sector are significantly shorter for the privately insured (Werbeck et al, 2019). Because they do not negotiate rates or build provider networks, private insurers mainly customize health plans and process, scrutinize, and deny claims.…”