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Public Health Insurance, Individual Health, and Entry into Self-Employment

Referierte Aufsätze Web of Science

Frank M. Fossen, Johannes König

In: Small Business Economics 49 (2017), 3, S. 647–669


We investigate the impact of a differential treatment of paid employees versus self-employed workers in a public health insurance system on the entry rate into self-employment. Health insurance systems that distinguish between the two sectors of employment create incentives or disincentives to start a business for different individuals. We estimate a discrete time hazard rate model of entry into self-employment based on representative household panel data for Germany, which include individual health information. The results indicate that an increase in the health insurance cost differential between self-employed workers and paid employees by €10 per month decreases the probability of entry into self-employment by 1.7% of the annual entry rate. This shows that entrepreneurship lock, which an emerging literature describes for the system of employer-provided health insurance in the USA, can also occur in a public health insurance system. Therefore, entrepreneurial activity should be taken into account when discussing potential health-care reforms.

Johannes König

Research Associate in the German Socio-Economic Panel study Department

Topics: Firms, Health

JEL-Classification: L26;I13;J2
Keywords: Health insurance, Health, Entrepreneurship lock, Self-employment