EFFECT OF MASS LAYOFFS ON HEALTH INSURANCE EXPENDITURES: THE CASE OF THE OSTRAVA REGION

The objective of the paper is to make an analysis of the development of health insurance expenditures on healthcare for employees from the mass layoffs from ArcelorMittal Ostrava, a.s. The paper tests the hypothesis that closing down a large heavy industry plant in a structurally affected region will increase the risk of morbidity of the population being laid off, which will secondarily lead to increased healthcare expenditures in the form of ambulatory treatment or hospitalisation. The quantification of this hypothesis is based on a unique non-public data set provided by Česká průmyslová zdravotní pojišťovna, a. s., the chief insurance company for employees of ArcelorMittal Ostrava, a.s. The data set contains information about 2,265 insured persons. After some necessary methodological modifications, the analysed data set contained 1,408 insured persons. The relationship between unemployment and health, expressed here as morbidity by cause, is estimated using relative risk indicators. The calculation of the risk rates uses the person-year concept. The analysis carried out showed that the unemployed show 11% higher morbidity than the employed. We observed an increase in the morbidity of the unemployed by 21% for tumour diseases, 11% for mental illnesses, 23% for diseases related to alcohol, and 27% for other diseases. The annual costs per insured person at a productive age in the period 2008-2013 were CZK 15,081 without a differentiation by status. We found a significant difference between the annual costs of treatment of employed (CZK 13,420 a year) and unemployed persons (CZK 17,635 a year). The difference of CZK 4,215 means that the costs of treating the unemployed are 31% higher than those for treating the employed, being higher than the relative increase in the risk of disease. The conclusions confirm findings of published international studies.