scholarly journals Impact of Gender and Age on Claim Rates of Dread Disease and Cancer Insurance Policies in Taiwan

2021 ◽  
Vol 19 (1) ◽  
pp. 216
Author(s):  
Chu-Shiu Li ◽  
Chih-Jen Hung ◽  
Sheng-Chang Peng ◽  
Ya-Lee Ho
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Reference Group ◽  
Upward Trend ◽  
Insurance Policies ◽  
Unique Data ◽  
Life Insurers ◽  
Gender And Age ◽  
The Impact

In this paper, the impact of both gender and age on the claim rates of dread disease and cancer insurance policies were examined using unique data taken from Taiwan’s private health insurance policies issued by non-life insurers during the 2012 to 2015 policy years. Those aged 30–39 served as the reference group. For the total number of dread disease policies, male insureds had a higher non-cancer claim probability than female insureds, while an age under 20 was associated with much lower claim rates for dread disease policies than for ages over 50. The claim rate for dread disease policies increased rapidly beginning at age 40 for both cancerous and non-cancerous diseases amongst male insureds. Amongst female insureds, those under 20 had much lower claim rates for dread disease policies. Only those aged 50–59 had a higher claim rate for non-cancerous diseases. For the total number of cancer insurance policies, male insureds had lower claim rates than female insureds, with an upward trend being associated with age. For male (female) insureds aged over 40 (20), the claim rates of cancer increased with age.

Economics, Ethics, and Health Insurance

2019 ◽  
pp. 497-520
Author(s):  
Daniel M. Hausman
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Drop Out ◽  
Insurance Markets ◽  
Care Provision ◽  
Insurance Policies ◽  
Health Insurance Markets ◽  
Health Care Policies ◽  
Care Allocation

Evaluating health care institutions and policies should depend on understanding the economic complexities of health care provision and on our values of compassion, choice, efficiency, fairness, and solidarity. These values may conflict, so applying them is difficult. We must also understand the problems with health care allocation, including employing markets. Regulations are needed first because of asymmetric information: doctors know more about treatments than patients and can exploit them. Second, health insurance is a better bargain for those who expect to be sick. Consequently, health insurance policies attract purchasers more likely to make claims. This adverse selection makes claims and premiums skyrocket, healthy people drop out, and private health insurance markets collapse, unless everyone is forced to buy insurance or insurers deny insurance to those with pre-existing conditions. Third is moral hazard: if insurance pays for a health problem, there is less incentive to avoid it or to economize on treating it. Health care policies must be economically sound and morally defensible.

scholarly journals Reflections on the role of less-than-comprehensive (exclusionary) private health insurance hospital products in the Australian healthcare system

2012 ◽  
Vol 36 (3) ◽  
pp. 273 ◽  
Author(s):  
Peter E. Thomas
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Private Health Insurance ◽  
Insurance Scheme ◽  
Policy Issues ◽  
The Public ◽  
Insurance Policies ◽  
Exclusionary Policies ◽  
First Time

The number of people in Australia that are currently covered by a hospital private health insurance product continues to rise every quarter. In September 2010, for the first time since the introduction of the public universal social insurance scheme, Medicare, more than 10 million persons in Australia are covered by private health insurance. Although the number of persons covered by private health insurance continues to grow, the quality and level of cover that members are holding is changing significantly. In an effort to limit premium rises and to reduce the benefits paid for treatment, private health insurers have introduced, and moved a large number of existing members to, less-than-comprehensive private health insurance policies. These policies, known as ‘exclusionary’ policies, are changing the dynamics of private health insurance in Australia. After examining the emergence and prevalence of these products, this commentary gives three different examples to illustrate how such products are changing the nature of private health insurance in Australia and are now set to create a series of policy issues that will require future attention.

scholarly journals The profiles of public and private patients in maternal healthcare: a longitudinal study to examine adverse selection

2019 ◽  
Vol 14 (1) ◽  
pp. 129-137
Author(s):  
Jananie William ◽  
Bronwyn Loong ◽  
Catherine Chojenta ◽  
Deborah Loxton
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Financial Incentives ◽  
Private Health Insurance ◽  
Service Use ◽  
Subsequent Pregnancy ◽  
Two Phase ◽  
Related Factors ◽  
Private Patient ◽  
The Impact

AbstractIn this article, we investigate differences in the profiles of patients within the Australian mixed public-private maternal health system to examine the extent of adverse selection. There are conflicting influences on adverse selection within the private health sector in Australia due to government regulations that incentivise lower risk segments of the population to purchase community-rated private health insurance. We use a two-phase modelling methodology that incorporates statistical learning and logistic regression on a dataset that links administrative and longitudinal survey data for a large cohort of women. We find that the key predictor of private patient status is having private health insurance, which itself is largely driven by sociodemographic factors rather than health-or pregnancy-related factors. Additionally, transitioning between the public-private systems for a subsequent pregnancy is uncommon; however, it is primarily driven by changes in private health insurance when it occurs. Other significant factors when transitioning to the private system for a second pregnancy are hypertension, increased access to specialists and stress related to previous motherhood experiences. Consequently, there is limited evidence of adverse selection in this market, with targeted financial incentives likely outweighing the impact of community rating even during childbearing years where private health service use increases.

scholarly journals State Health Insurance Regulations and the Price of High-Deductible Policies

2008 ◽  
Vol 11 (2) ◽  
Author(s):  
Amanda E. Kowalski ◽  
William J. Congdon ◽  
Mark H. Showalter
Keyword(s):  
Health Insurance ◽  
Family Policy ◽  
State Level ◽  
Demographic Characteristics ◽  
State Health ◽  
Data Set ◽  
Insurance Policies ◽  
State Health Insurance ◽  
Rich Data ◽  
The Impact

This study examines the impact of state health insurance regulations on the price of high-deductible family and individual polices in the nongroup market. We use a unique and rich data set on actual insurance policies sold through a large Internet health insurance distributor to examine the impact of various regulations on policy prices, controlling for policy characteristics, demographic characteristics of the purchasers, and state-level demographics. We also use data from a single major insurance firm that provided offer prices for a family policy from a set of randomly selected zip codes. Both datasets suggest a strong statistical relationship between regulation and insurance prices.

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