Doctor-Visit Co-Payment Exemption for Children: First Look at the Data

This paper uses the abolition of children's doctor-visit co-payments effective since April 2009 as a natural experiment to estimate the effect of those co-payments on the number of doctor visits made by children. As the policy change involved only children, we are able to use the adult part of the population as a control group in a difference-in-difference estimation. The paper approximates the number of doctor visits by consumption of prescription drugs, as visiting a doctor is the only way to obtain a prescription. Using three different pre-reform periods (January, February, and March 2009) and two post-reform periods (April and May 2009) the estimates reveal no overall effect of doctor-visit co-payments on the number of children's doctor visits. Less convincingly and more tentatively, the estimates suggest a strategic shift of children's doctor visits away from the last pre-reform toward the first post-reform month.