Direct evidence of risk aversion as a source of advantageous selection in health insurance

2011 ◽  
Vol 113 (2) ◽  
pp. 180-182 ◽  
Author(s):  
Hendrik Schmitz
2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yawen Jiang ◽  
Weiyi Ni

Abstract Background Information on risk selection is important for the regulation and development of supplemental private health insurance (PHI). The research on risk selection into supplemental PHI has been documented in several developed countries where the regulation of the PHI markets was relatively mature. However, evidence on this important aspect of the supplemental PHI market in China is still absent in the literature. The private insurers in China were not prohibited from discrimination against pre-existing conditions and did not guarantee ongoing enrolment. Therefore, the direction and degree of risk selection could not be inferred using the evidence from the other countries. To provide evidence on risk selection into supplemental PHI in China, we conducted a cross-sectional analysis using data from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). Results Using probit models, we found that individuals having better self-reported general health were more likely to enrol in PHI in China, suggesting advantageous selection. This result was confirmed by an alternative analysis using an instrumental variable. We also adjusted the realized occurrence of hospitalization by excluding potential moral hazard effect and showed that the adjusted hospitalization risk was negatively associated with PHI enrolment, which also indicated advantageous selection. Conclusions The findings suggested potential over-insurance of healthier individuals or under-insurance of less healthy individuals. The regulation of the PHI market in China should aim to address the inefficiency. The current study could also contribute to the information base for policymakers in countries where the PHI markets similarly lack strong regulation.


2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Hao Wang

AbstractA previous study finds that increased competition in health care markets improves social welfare, although consumers use “too much” health care when they have health insurance. The analysis assumes that consumers have a constant Arrow-Pratt coefficient of absolute risk aversion. This note shows that this finding can be extended to the case where consumers are simply risk averse. Furthermore, if insurers offered insurance policies with slightly lower usage prices than the equilibrium level, social welfare would be improved.


2021 ◽  
Vol 30 (2) ◽  
pp. 457-474
Author(s):  
Marijana Ćurak ◽  
◽  
Dujam Kovač ◽  
Klime Poposki

During the pandemic, health care services have gained in importance. One of the ways used to finance these services is through voluntary private health insurance. Existing studies on the demand for voluntary private health insurance are based predominantly on the micro-economic level. Therefore, the aim of this paper is to analyse the factors of demand at the macro-economic level. The analysis covers economic and demographic factors, the quality of the public health care system, risk aversion and the status of the population’s health. The empirical research is based on the databases of 29 European countries in the period from 2013 to 2017 and on the dynamic panel model. The results of the empirical analysis revealed that income, price, urbanization, health care system quality, risk aversion/education and self-perceived health are important determinants of demand for voluntary private health insurance in European countries.


Author(s):  
Hendrik Schmitz ◽  
Svenja Winkler

The terms information and risk aversion play central roles in healthcare economics. While risk aversion is among the main reasons for the existence of health insurance, information asymmetries between insured individual and insurance company potentially lead to moral hazard or adverse selection. This has implications for the optimal design of health insurance contracts, but whether there is indeed moral hazard or adverse selection is ultimately an empirical question. Recently, there was even a debate whether the opposite of adverse selection—advantageous selection—prevails. Private information on risk aversion might weigh out information asymmetries regarding risk type and lead to more insurance coverage of healthy individuals (instead of less insurance coverage in adverse selection). Information and risk preferences are important not only in health insurance but more generally in health economics. For instance, they affect health behavior and, consequently, health outcomes. The degree of risk aversion, the ability to perceive risks, and the availability of information about risks partly explain why some individuals engage in unhealthy behavior while others refrain from smoking, drinking, or the like. Information has several dimensions. Apart from information on one’s personal health status, risk preferences, or health risks, consumer information on provider quality or health insurance supply is central in the economics of healthcare. Even though healthcare systems are necessarily highly regulated throughout the world, all systems at least allow for some market elements. These typically include the possibility of consumer choice, for instance, regarding health insurance coverage or choice of medical provider. An important question is whether consumer choice elements work in the healthcare sector—that is, whether consumers actually make rational or optimal decisions—and whether more information can improve decision quality.


2018 ◽  
Vol 108 (8) ◽  
pp. 2048-2087 ◽  
Author(s):  
Marika Cabral ◽  
Michael Geruso ◽  
Neale Mahoney

A central question in the debate over privatized Medicare is whether increased government payments to private Medicare Advantage (MA) plans generate lower premiums for consumers or higher profits for producers. Using difference‑in‑differences variation brought about by a sharp legislative change, we find that MA insurers pass through 45 percent of increased payments in lower premiums and an additional 9 percent in more generous benefits. We show that advantageous selection into MA cannot explain this incomplete pass‑through. Instead, our evidence suggests that market power is important, with premium pass‑through rates of 13 percent in the least competitive markets and 74 percent in the most competitive. (JEL G22, H51, I11, I13, I18)


2020 ◽  
Vol 122 ◽  
pp. 63-100
Author(s):  
Kyungsun Kim ◽  
S. Hun Seog

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