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Are private health insurance subscribers unsatisfied with the Spanish National Health System?

Costa-i-Font, Joan ORCID: 0000-0001-7174-7919 and Jofre-Bonet, Mireia (2006) Are private health insurance subscribers unsatisfied with the Spanish National Health System? Geneva Papers on Risk and Insurance: Issues and Practice, 31 (4). pp. 650-668. ISSN 1018-5895

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Identification Number: 10.1057/palgrave.gpp.2510102


The percentage of population having supplementary private health insurance (PHI) is related to the perceived quality of the National Health System (NHS). In turn, PHI purchase decisions influence the NHS quality given that the number of PHI subscribers determines NHS quality indicators related to congestion. On the other hand, being satisfied with the NHS includes an assessment of the NHS as a whole that goes beyond the mere perception of its quality. This paper estimates the probabilities of purchasing PHI and of being satisfied with the NHS as two simultaneous processes taking into account that NHS quality may influence but also be influenced by these two outcomes. We use data from a Spanish representative survey released in 2002. Following this empirical strategy we find that: (1) the likelihood of having PHI and being satisfied with the NHS is negatively and simultaneously associated; and, (2) naïve estimation models may be underestimating the impact of the NHS perceived quality on the likelihood of purchasing PHI.

Item Type: Article
Official URL:
Additional Information: © 2006 The International Association for the Study of Insurance Economics
Divisions: European Institute
LSE Health
Psychological and Behavioural Science
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 23 Nov 2009 14:43
Last Modified: 16 May 2024 00:29

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