nep-ias New Economics Papers
on Insurance Economics
Issue of 2011‒01‒03
eight papers chosen by
Soumitra K Mallick
Indian Institute of Social Welfare and Business Management

  1. Exclusive contracts in health insurance By Rahkovsky, Ilya
  2. Demand for hospital care and private health insurance in a mixed publicprivate system: empirical evidence using a simultaneous equation modeling approach By Chai Cheng, T;; Vahid, F;
  3. Can combining credit with insurance or savings enhance the sustainability of microfinance institutions? By Koen Rossel-Cambier
  4. Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China By Yong HE; Jacky MATHONNAT; Martine AUDIBERT
  5. Innovations in Financing Food Security By Gilberto M. Llanto; Jocelyn R. Badiola
  6. Healthcare Delivery and Stakeholder’s Satisfaction under Social Health Insurance Schemes in India: An Evaluation of Central Government Health Scheme (CGHS) and Ex- servicemen Contributory Health Scheme (ECHS) By Sukumar Vellakkal; Shikha Juyal; Ali Mehdi
  7. Effects of the UI benefit extensions: evidence from the monthly CPS By Shigeru Fujita
  8. Preparing for Basel IV: why liquidity risks still present a challenge to regulators in prudential supervision By Ojo, Marianne

  1. By: Rahkovsky, Ilya
    Abstract: Competition between insurance companies for employees of a firm often increases the prices and reduces the availability of high-quality health plans offered to employees. An insurance company can reduce competition by signing an exclusive contract, which guarantees that the company is the only insurance provider. The study assesses whether exclusive contracts can alleviate the negative consequences of competition. Using the nation-wide survey of employers, I find that exclusive insurers charged 39-42 less for a unit of insurance quality than non-exclusive insurers. Furthermore, I find that the pattern of insurance quality dispersion is consistent with the exclusive insurers offering more high quality plans.
    Keywords: health insurance; exclusive contract; subsidy; vertical restraint; signaling
    JEL: I11 D86 G22 L42 J32
    Date: 2010–12–15
  2. By: Chai Cheng, T;; Vahid, F;
    Abstract: This paper examines the determinants of hospital stay intensity, the decision to seek hospital care as a public or private patient and the decision to purchase private hospital insurance. We describe a theoretical model to motivate the simultaneous nature of these decisions. For the empirical analysis, we develop a simultaneous equation econometric model that accommodates the count data nature of length of stay and the binary nature of the patient type and insurance decisions. The model also accounts for the endogeneity of the patient type and insurance binary variables. The results suggest that there is some weak evidence of endogeneity between the decision to purchase insurance and the intensity of hospital use. We do not ¯nd signi¯cant moral hazard effects of private hospital insurance on the intensity of private hospital care. The results also indicate that the length of hospital stay for private patients is shorter than for public patients.
    Keywords: Demand for Hospital Care; Private Hospital Insurance; Public Private Mix; Moral Hazard
    JEL: I11 H42 C31 C15
    Date: 2010–10
  3. By: Koen Rossel-Cambier
    Abstract: Worldwide, microcredit organizations are gradually transforming to multi-servicing organizations offering additional financial services. This paper examines whether combining microcredit with insurance and/or savings enhances their economic performance by increasing their efficiency, productivity, sustainability or portfolio quality indicators. Using cross-sectional data from 250 microfinance institutions (MFIs) from Latin America and the Caribbean, it compares MFIs offering credit only with those combining credit with respectively savings and insurance. By using multiple regression analysis, this research finds positive effects of both savings and insurance on the efficiency and productivity of MFIs. Still, this research didn't find significant results with relation to the sustainability and portfolio quality of MFIs. Overall, taking into account various risks, combined microfinance can enhance organisational efficiency and productivity because of the different economies of scope which can be achieved. This reveals especially for large and mature MFIs which already exhibit readiness in terms of human, financial, and organizational resources to deal with the complexity of delivering multiple financial services.
    Keywords: performance; microfinance; combined microfinance; microinsurance; microcredit; microsavings; Latin America and the Caribbean
    JEL: G21 G22 L31 O54
    Date: 2010–12
  4. By: Yong HE (Centre d'Etudes et de Recherches sur le Développement International); Jacky MATHONNAT (Centre d'Etudes et de Recherches sur le Développement International); Martine AUDIBERT (Centre d'Etudes et de Recherches sur le Développement International)
    Abstract: 1989-2006 is a period of the start and the end of deregulation of Chinese health care sector and of disintegration of rural cooperative insurance system. During this period, the government health policy has turned healthcare providers all alike into profit seeking entities. Face to perverse effects, by 2003, Chinese government begun to restore rural cooperative insurance system. From CHNS data source, we constitute two samples: 89-93 and 04-06 with respectively 2117 and 2594 rural patients surveyed roughly in the same villages in 9 Chinese provinces to compare their health choice behaviors with the evolution of price, income, distance, insurance, age, and regional inequality. Using Mixed Multinomial Logit (MMNL) estimations, we have obtained three main results. First, even in both periods there is clear price effect, in 04-06 it tends to be weaker, and heterogeneity in price preference has increased. This corresponds well the fact that between the two periods price level has significantly increased and price variation reduced. Second, there is a stronger negative distance effect and heterogeneity in 2004-06, while in 89-93 this negative impact was lower and absent for providers farther than 10km. One interpretation is the existence of a substitution effect: when patients have less possibility to discriminate providers by price, they increase their preference in choice by distance. Third, while, wealth effect exists in some choices in 89-93, it becomes absent in 04-06. Explanations may be that one the one hand both supply side and demand side conditions on health care have been improved even, to less extent though, for the poor, and on the other hand, health care is necessary goods and is price inelastic. But meanwhile, we observed catastrophic effect for the poor: the poorer patients have their share of consumption in income more decreased after health care.
    Keywords: Empirical approach, health care demand, mixed logit model, insurance, China
    JEL: C25 I18 I11
    Date: 2010
  5. By: Gilberto M. Llanto; Jocelyn R. Badiola (Philippine Institute for Development Studies)
    Abstract: A recent publication of the UN Food and Agricultural Organization (FAO) has highlighted the food insecurity problem facing the globe: food production will have to increase by 70% in 2050 to keep up with a global population that is projected to grow from 6 billion to 9 billion. There has to be more investments in agriculture to improve productivity, which will be critical to the goal of achieving food security. There is scope for governments and the private sector cooperation in food production. The paper discusses innovative financing schemes geared to food production and identifies policy gaps, that is, areas where governments could intervene to enhance the workings of the market.
    Keywords: food insecurity, innovative financing schemes, value chain financing, covariant risks, risk management tools, index‐based insurance, warehouse receipts lending, trade finance
    JEL: Q18
    Date: 2010
  6. By: Sukumar Vellakkal; Shikha Juyal; Ali Mehdi (Indian Council for Research on International Economic Relations)
    Abstract: This study attempted to evaluate the working of the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) by assessing patient satisfaction as well as the issues and concerns of empanelled private healthcare providers. The study is based on a primary survey of 1,204 CGHS and 640 ECHS principal beneficiaries, 100 empanelled private healthcare providers and 100 officials of the schemes across 12 Indian cities. We have found that patients are reasonably well satisfied with the healthcare services of both empanelled private healthcare providers and the dispensaries-polyclinics but are relatively more satisfied with the former than the latter. We also found that beneficiaries are willing to pay more for better quality services. Though the schemes provide comprehensive healthcare services, the beneficiaries incur some out-of- pocket health expenditure while seeking healthcare. Furthermore, beneficiaries are not in favour of the recent proposal to replace the schemes with health insurance for several reasons. The empanelled private healthcare providers are dissatisfied with the terms and conditions of empanelment, especially the low tariffs for their services as compared to prevailing market rates and the delays in reimbursements from the schemes. We suggest that appropriate efforts be undertaken to enhance the quality of healthcare service provided in the dispensaries-polyclinics of the CGHS and ECHS as well as to address the issues and concerns of empanelled private healthcare providers to ensure better healthcare delivery and for a long-term, sustainable public-private partnership.
    Keywords: CGHS, ECHS, patient satisfaction, willingness to pay, empanelled private healthcare providers
    JEL: H30 H51 H53 I19
    Date: 2010
  7. By: Shigeru Fujita
    Abstract: Using the monthly CPS, the author estimates unemployment-to-employment (UE) transition rates and unemployment-to-inactivity (UN) transition rates by unemployment duration for male workers. When estimated for the period of 2004-2007, during which no extended benefits are available, both of the transition-rate profiles show clear patterns consistent with the expiration of regular benefits at 26 weeks. These patterns largely disappear in the profiles for the period of 2009-2010, during which large-scale extensions have become available. The author conducts counterfactual experiments in which the estimated profiles for 2009-2010 are replaced by the hypothetical profiles inferred from the ones for 2004-2007. The results indicate that the benefit extensions in recent years have raised male workers' unemployment rate by 0.9-1.7 percentage points. Roughly 50-60 percent of the total increase is attributed to the effects on UE transition rates and the remaining part is accounted for by the effects on UN transition rates.
    Keywords: Unemployment insurance ; Unemployment
    Date: 2010
  8. By: Ojo, Marianne
    Abstract: This paper considers and assesses various explanations attributed as principal factors of the recent Financial Crisis. In particular, it focuses on two principal regulatory tools which constitute the basis of the framework promulgated by recent Basel Committee's initiatives, that is, Basel III. These two regulatory tools being capital and liquidity requirements. Various conclusions have been put forward to explain what triggered the recent Financial Crisis. This paper aims to explain why the Basel Committee's liquidity requirements and present proposals aimed at addressing liquidity risks, still represent a very modest milestone in efforts aimed at addressing challenges in prudential regulation and supervision. Even though problems attributed to capital adequacy requirements are considered by many authorities to have triggered the recent Crisis, the paper will highlight how runs on banks are triggered by liquidity crises and that liquidity risks cannot be isolated from systemic risks. In so doing, it will incorporate the roles assumed by information asymmetries and market based regulation – hence elaborate on how market based regulation could serve to address problems which trigger liquidity risks. Imperfect knowledge being a factor which is contributory to liquidity crises and bank runs, and market based regulation being essential in facilitating disclosure - since the Basel Committee's focus on banks and prudential supervision cannot on its own, address the challenges encountered in the present regulatory environment. Furthermore, it will address measures and proposals which could serve as bases for future regulatory reforms - as well as criticisms and challenges still encountered by recent Basel Committee initiatives.
    Keywords: capital; liquidity; Basel III; Basel Committee; lender of last resort; banks; insurance; securities; information asymmetry; market based regulation; bail outs; disclosure; moral hazard; Dodd Frank Act; Financial Crisis
    JEL: K2 E52 D8
    Date: 2010–12–22

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