Moral hazard and selection for voluntary deductibles

Rob J.M. Alessie, Viola Angelini, Jochen O. Mierau, Laura Viluma*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


This paper investigates whether the voluntary deductible in the Dutch health insurance system reduces moral hazard or acts only as a cost reduction tool for low-risk individuals. We use a sample of 14,089 observations, comprising 2,939 individuals over seven waves from the Longitudinal Internet Studies for the Social sciences panel for the analysis. We employ bivariate models that jointly model the choice of a deductible and health care utilization and supplement the identification with an instrumental variable strategy. The results show that the voluntary deductible reduces moral hazard, especially in the decision to visit a doctor (extensive margin) compared with the number of visits (intensive margin). In addition, a robustness test shows that selection on moral hazard is not present in this context.

Original languageEnglish
Pages (from-to)1251-1269
Number of pages19
JournalHealth Economics (United Kingdom)
Issue number10
Early online date31 Jul 2020
Publication statusPublished - 1 Oct 2020


  • deductible
  • health insurance
  • moral hazard
  • selection


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