Pure Versus Mutual Health Insurance: Evidence From Swedish Historical Data

Using data from voluntary Swedish health insurance societies 1902-1910, this article analyzes the coexistence of pure and mutual insurance societies where pure societies are characterized by charging ex ante premiums only while mutuals in addition charge ex post assessments. On average, mutual insurance societies are found to be larger and to offer greater insurance coverage per member. Pure insurance societies have, on average, higher insurance coverage per day, greater mean levels of moral hazard controls, a higher mean number of policy categories, and greater longevity.