期刊名称：DIW Diskussionspapiere / Deutsches Institut für Wirtschaftsforschung, Berlin
出版年度：2009
卷号：2009
出版社：Deutsches Institut für Wirtschaftsforschung, Berlin
摘要：Sick leave payments represent a significant portion of public health
expenditures and labor costs. Reductions in replacement levels are a commonly
used instrument to tackle moral hazard and to increase the efficiency of the
health insurance market. In Germany's Statutory Health Insurance (SHI) system,
the replacement level for periods of sickness of up to six weeks was reduced
from 100 percent to 80 percent of an employee's gross wage at the end of 1996.
At the same time, the replacement level for individuals absent for a long-term
period, i.e., from the seventh week onwards, was reduced from 80 to 70 percent.
We show theoretically that the net reform effects on long-term absenteeism can
be disentangled into a direct and an indirect effect. Using SOEP data, a natural
control group, and two different treatment groups, we estimate the net and the
direct effect on the incidence and duration of long-term absenteeism by
difference-in-differences. Our findings suggest that, on population average, the
reforms have not affected long-term absenteeism significantly, which is in
accordance with our theoretical predictions, assuming that employees on
long-term sick leave are seriously sick. However, we find some heterogeneity in
the effects and a small but significant decrease in the duration of long-term
absenteeism for the poor and middle-aged full-time employed persons. All in all,
moral hazard and presenteeism seem to be less of an issue in the right tail of
the sickness spell distribution. Finally, our calculations suggest that from
1997 to 2006, around five billion euros were redistributed from persons on
long-term sick leave to the SHI insurance pool.
关键词：Long-term absenteeism, sick pay, moral hazard, natural experiment, SOEP
