Mercy Raquel Orellana Bravo, Juan Andrés Piedra Peña, Luis Santiago Sarmiento Moscoso


The aim of this study is to estimate the presence of moral hazard in the Ecuadorian health system, understood as an over-utilization of it. For this, a binomial logit model, which measures the probability of use of health services between insured and uninsured people is used. The results show evidence of moral hazard for individuals who are insured, mainly for adults over 60 years. In addition, it is noted that when having extra expenses that are not covered by insurance, insured people tend to reduce the use of medical services.

Full Text:



Arrow, K. J. (1963). Uncertainty and the Welfare Economics of Medical Care. The American Economic Review, 53, 941–973.

Bajari, P., Dalton, C., Hong, H., Khwaja, A. (2014). Moral hazard, adverse selection, and health expenditures: A semiparametric analysis. The RAND Journal of Economics, 45, 747–763.

Bertranou, F. (1998). Health Care Services Utilization and Health Insurance Coverage: Evidence from Argentina. Revista de Análisis Económico – Economic Analysis Review, 13, 25–52.

Cameron, A., Trivedi, P. K. (1991). The role of income and health risk in the choice of health insurance. Journal of Public Economics, 45, 1–28.

Cameron, A., Trivedi, P., Milne, F., Piggott, J. (1988). A Microeconometric Model of for Health Care the Demand and Health Insurance in Australia. Review of Economic Studies, 55, 85–106.

Chiappori, P., Durand, F., Geoffard, P. Y. (1998). Moral hazard and the demand for physician services: First lessons from a French natural experiment. European Economic Review, 42, 499–511.

Gertler, P., Locay, L., Sanderson, W. (1987). Are user fees regressive? The welfare implications of health care financing proposals in Peru. Journal of Econometrics, 36, 67–88.

Grenee, W. (2012). Econometric Analysis (7th ed.). New York, NY: Pearson Education.

Höfter, R. H. (2006). Private health insurance and utilization of health services in Chile. Applied Economics, 38, 423-439.

Keane, M., Stavrunova, O. (2016). Adverse selection, moral hazard and the demand for Medigap insurance. Journal of Econometrics, 190, 62–78.

Manning, W., Newhouse, J., Duan, N., Keeler, E. B., Leibowitz, A. (1987). Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment. The American Economic Review, 77, 251–277.

Newhouse, J. (1993). Free for all?: lessons from the RAND health insurance experiment. Harvard University Press.

Pauly, M. (1968). The Economics of Moral Hazard: Comment. The American Economic Review, 58, 531–537.

Rothschild, M., Stiglitz, J. (1976). Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information. The Quarterly Journal of Economics, 90, 629–649.

Sapelli, C., Vial, B. (2003). Self-selection and moral hazard in Chilean health insurance. Journal of Health Economics, 22, 459-476.

Sindelar, J. L. (1982). Differential Use of Medical Care by Sex. Journal of Political Economy, 90, 1003–1019.

Van de Ven, W., Van Praag, B. (1981). The demand for deductibles in private health insurance. Journal of Econometrics, 17, 229–252.

Zweifel, P., Manning, W. (2000). Moral hazard and consumer incentives in health care. In J. Culyer, J., Newhouse, J. (Editors), Handbook of Health Economics. North Holland; 409–459


  • There are currently no refbacks.

Creative Commons License

All the articles published in JSEG are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.