Private health insurance expansion leads to poorer overall public health

People with private health insurance can jump the public healthcare queue by using private health services instead. Is there really anything wrong with that?

There are two main theories:

1. If the wealthiest people use private health services more, the public healthcare system will have more capacity for the rest of us.
2. Private health services divert resources away from the public healthcare system, which consequently becomes worse.

But which one of these theories is most correct? Researchers at the Norwegian University of Science and Technology (NTNU) have been investigating this, and the results are now in.

Public health is deteriorating

Our findings suggest that an increase in private health insurance uptake leads to poorer health in the population over time."

Professor Pål Erling Martinussen, Department of Sociology and Political Science, NTNU

Private health insurance has become much more common in several European countries over the past few decades. In collaboration with PhD research fellow Oda Nordheim, Martinussen has studied developments in 20 countries during the period 2002–2022. They have used data from over 300,000 people.

Worse for people with the lowest levels of education

"People with a low level of education are more likely to report poor health if they live in a country where uptake of private health insurance has increased," explained Nordheim.

A lower level of education is often associated with lower income, at least on average. Of course, some people have private health insurance through their jobs. However, the figures show that it is often people with the least financial resilience who are most affected.

Paying for private health services may be beneficial for those who can afford to do so, but it comes at the expense of others.

"The negative health effects on the population as a whole outweigh the benefits that private health insurance provides to individuals," concluded Martinussen.

The researchers are therefore of the opinion that European policymakers must implement strategies to counteract the potential negative side effects of private health insurance.