The effect of deductibles on healthcare expenditure: new evidence for Switzerland.

Switzerland's statutory health insurance system is compulsory, but offers consumers a choice between different deductible levels. Faced with a steady growth of healthcare expenditure (HCE), both chambers of the national parliament recently voted in favour of increasing the minimum deductible from CHF 300 to CHF 500. In this study, we use claims data from the largest Swiss health insurer to compare the per capita HCE of adults who voluntarily chose different deductible levels. Specifically, we focus on individuals with the minimum deductible (CHF 300), the proposed new minimum (CHF 500), and the maximum deductible (CHF 2500). Applying matching and regression analysis, we find an 11% and 27% reduction in HCE, respectively, of the higher deductibles. The effects are stronger for outpatient care and drugs and weaker for inpatient and long-term care. If the minimum deductible increases to CHF 500 and insurers pass through the estimated CHF 900 reduction in per capita HCE, the average consumer will benefit by CHF 772. No consumer will lose because the maximum additional copayment is capped at CHF 200.