Abstract: This paper investigates the role of private health insurance (PHI) within Sweden’s universal healthcare system, focusing on the trade-offs between efficiency and equity. Leveraging comprehensive administrative data from 2006 to 2015, we use employer-based variation and matched difference-in-differences designs to examine PHI’s impact on healthcare consumption, waiting times, and health outcomes. We document a steep income gradient in PHI take-up, with higher-income individuals accessing faster specialist care and reduced public sector queues. While PHI modestly reduces waiting times system-wide, it generates negative congestion externalities for non-covered individuals. Importantly, PHI improves survival rates following cancer diagnoses, suggesting tangible health returns for those able to access it. Our results highlight that the distributional implications of PHI under universal coverage are first-order, raising normative questions about equity and the optimal public-private mix in healthcare provision.

Discussant: David Seim (Stockholm University).

Chair: Isabel Micó.

Contact: Isabel Micó.

Location: Meeting room DG Economics.

Timetable: 2025.10.08 (12:00-13:00).