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PLANES MíNIMOS OBLIGATORIOS EN MERCADOS DE SEGUROS DE SALUD SEGMENTADOS

DOI: 10.4067/S0718-52862009000200004

Keywords: health insurance, minimum basket of services, managed competition.

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Abstract:

we analyze the effect of introducing a minimum mandatory health insurance plan in a segmented market in which high risks are affiliated to the public insurer and low risks to the private ones (market segmentation is endogenously obtained in our model). we assume both types of insurers must provide the basic plan, insurance is compulsory, and there is a minimum premium regulation. when we compare the equilibriums pre and post introduction of the basic health insurance plan, we find that an implicit subsidy mechanism operates that gives some solidarity lo the system, even though no explicit risk compensation mechanism is introduced. for this implicit subsidy mechanism lo operate, it is fundamental that not only the price of the basic plan is regulated but also the quality of the services included in such plan, and that the regulator is able lo guarantee private insurers do offer the minimum plan lo all risks.

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