‘Must-Trade and Catch-Up’ – Do the Self-Employed Under-Invest in Their Health?

[eng] This study analyses the healthcare consumption of self-employed workers (SEW) versus employees, at different ages in France. It is based on 2012 cross-sectional data from the French Health, Healthcare and Insurance Survey (ESPS) matched with National Health Insurance data. We decompose healthcare demand (ambulatory and inpatient care) at different ages and by gender using a two-step model. The results show that, ceteris paribus, SEW (especially men) tend to consume less ambulatory care in the early stages of their working life, as their job is more demanding (‘must-trade’ effect), while their consumption gradually increases with age, reaching the levels of other categories of workers after retirement (‘catch-up’ effect). These results, in line with economic theory, suggest that SEW’s health declines faster over the life cycle. From a public policy perspective, they challenge, on the grounds of public health, the EU2020 strategy advocating the development of SEW in Europe.