Saving for health care: an interesting option to increase the attractiveness of voluntary deductibles

__Abstract_ In the last decade, the average public health expenditures per capita in OECD countries increased by 76 per cent (OECD, 2012). This increase is a serious threat to the fiscal sustainability of health-care spending and therefore of great concern to policymakers in many countries. One of the drivers of health-care expenditures is moral hazard. Moral hazard refers to the change in health behaviour and health-care consumption caused by the fact that the insurance reimburses the costs (Zweifel and Manning, 2000). To counteract moral hazard, the German, Dutch and Swiss basic health insurance schemes include the option of a voluntary deductible. A voluntary deductible implies that people can choose to pay their health-care expenses up to a certain amount out-of-pocket in return for a premium rebate. In these countries however, the premium rebate—and thereby the attractiveness of voluntary deductibles—is reduced by the risk equalisation scheme. In this article, saving for health care in combination with a voluntary deductible is proposed as an interesting option to increase the attractiveness of voluntary deductibles in these schemes.