Riesgo moral y selección adversa en el sistema general de aseguramiento de salud para el Ecuador año 2013

Abstract

This study analyzes a topic of great interest in the context of designs of public policies, such as the asymmetric information in the health care system in Ecuador. This study has not been research deeply in our country, it is the need to study the private and public health assurance, where we will discuss the factors that influence such as individuals at the time of choosing an insurance and their subsequent behavior in the usage of these services against the principal, it gets problems caused by the asymmetry of the information in the system as: adverse selection and moral hazard. To the study of these problems of asymmetry of information, it is used models of discrete dependent variable, such as the binomial logit and multinomial, where the variables of interest to the case of adverse selection are the risk factors related to each one of the agents, and in the case of moral hazard has been used as main variables the cost incurred by insured in the last 30 days when they get access to health services and that they are not covered by the insurance, the insurance type that the agent has, too. Main results obtained in this investigation are that owed to not enoughinformation and the way of structuring of the available database, it is not possible to conclude the existence of adverse selection in the population; also the risk factors do not turn out to be influential at the moment of choosing an insurance type, being the social economic factors the most influential such as: the area of housing, the genre and labor conditions. On the other hand, we found that the effect of determining expense has on the agent`s behavior of do not reveal the existence of a moral hazard, however there is over consumption for formal medical services of the agents that just have a mandatory social insurance and who have more than one insurance, are being the poorest fifth one who get access to these services, which might be generated problems of performance in the ecuadorian health care system.