Voluntary deductible choice in Dutch health insurance

Since 2006, the number of insured who chooses to voluntarily increase the deductible in Dutch health insurance has been tripled. This thesis analyzes this choice for all Dutch insured in the years 2006-2013 and identifies characteristics of insured with a voluntary deductible. Additionally, we identify characteristics of switchers (i.e. insured who moved into an insurance plan with voluntary deductible and insured who moved out), and the number and characteristics of insured who possibly made uninformed decisions regarding the voluntary deductible. Our results show that young males, living in zip codes with a high education level and a high average household income are most likely to opt for a voluntary deductible. Moreover, insured with a voluntary deductible have lower healthcare expenditures, on average €1341, than insured without a voluntary deductible. Insured who moved into an insurance plan with a voluntary deductible generally have low health care expenditure in the past while insured who moved out a voluntary deductible plan had generally high healthcare expenditures in the past. This suggests that many insured make informed decisions with regard to the voluntary deductible. However, we also find that, in 7% of all cases, insured with two consecutive years of high healthcare expenditures incurred a financial loss due to choosing a voluntary deductible in the third year. This group consists of a relatively large share of chronically ill, elderly, and insured living in a zip code with a high average household income. This percentage declined over the years, indicating that an increased number of insured made well-informed decisions. The information provided by our study will be useful for policymakers as it provides an overview of which insured opt for a voluntary deductible. Furthermore, it could be used to target information campaigns to these insured who are financially worse off due to the voluntary deductible.