nep-ias New Economics Papers
on Insurance Economics
Issue of 2015‒08‒13
fourteen papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Building Systems for Universal Health Coverage in South Korea By Sanggon Na; Soonman Kwon
  2. Human Capital Risk, Contract Enforcement, and the Macroeconomy By Krebs, Tom; Kuhn, Moritz; Wright, Mark L. J.
  3. Partial insurance and investments in children By Pedro Carneiro; Rita Ginja
  4. Reconciling insurance with market discipline: A blueprint for a European fiscal union By Dolls, Mathias; Fuest, Clemens; Heinemann, Friedrich; Peichl, Andreas
  5. Testing the Link between Accessible Export Finance and Insurance, and Regional Trade Growth in Africa and Asia: A Role for Regional Export Credit and Investment Guarantee Agency ECIGA) By Brunner, Hans-Peter
  6. The Medicaid Program By Thomas Buchmueller; John C. Ham; Lara D. Shore-Sheppard
  7. Working to get fired? Regression discontinuity effects of unemployment benefit eligibility on prior employment duration By Pedro S. Martins
  8. The redistribution and insurance value of welfare reform By Jonathan Shaw
  9. Origin and Development of the Quasi-Market System in Japan: From healthcare to welfare, and to education (Japanese) By USHIRO Fusao
  10. The impact of short- and long-term participation tax rates on labor supply By Bartels, Charlotte; Pestel, Nico
  11. Creating a Dashboard for Pioneer ACOs By Craig D. Schneider
  12. Estimating the Value of Life, Injury, and Travel Time Saved Using a Stated Preference Framework By Naghmeh Niroomand; Glenn P. Jenkins
  13. The Impact of Short- and Long-Term Participation Tax Rates on Labor Supply By Charlotte Bartels; Nico Pestel
  14. A capital markets union for Europe: The relevance of banks and markets By Demary, Markus; Diermeier, Matthias; Haas, Heide

  1. By: Sanggon Na; Soonman Kwon
    Abstract: This paper broadly examines the development process of Korea’s health care system toward the achievement of Universal Health Coverage. Korea implemented a series of health care reforms after a rapid expansion of population coverage to improve efficiency and equity in financing and delivery of health care. The authors also investigate changes in the governance structure of Korea’s national health Insurance, which is now represented by two agencies: National Health Insurance Service (NHIS) and Health Insurance Review and Assessment Service (HIRA). Health insurance agencies have improved the accountability and transparency of the health insurance system, thanks to the ICT-based centralized claim review and assessment. Lessons and challenges from Korea’s experiences and achievements on the road to UHC could provide valuable policy implications to low- and middle-income countries.
    Keywords: health care providers, health information system, health insurance coverage, access to health care, employment, risks, fee- for-service, health planning, health insurance ... See More + system, physician, stroke, financing, informal sector, pharmacists, information system, health reforms, income, quality of health care, fee for service, health care utilization, fee-for-service, doctors, fee-for- service system, health care reform, health economics, hospital sector, primary care, pocket payment, monitoring, cost sharing, health insurance, health care, financial protection, health insurance expenditure, social insurance contributions, health care facilities, incentives, national health insurance, health, health care reforms, provision of services, pocket payments, contribution rates, information systems, public health, life expectancy, quality of health, knowledge, health sector, insurance funds, health information systems, choice, demand for health care, cost effectiveness, multiple insurers, private hospitals, health institutions, costs, pharmaceutical spending, cost control, patients, patient, public long- term care insurance, aging, social insurance, health insurance scheme, marketing, medical care, insurers, health care quality, social security, risk sharing, health care coverage, social development, insurance coverage, public insurance, mortality, financial incentive, health care system, health promotion, administrative costs, health information, health spending, reimbursement rates, social marketing, unemployment, equity, health specialist, workers, social health insurance, fee schedule, surgery, public long-term care, health care provision, incentives for providers, health-care, fee schedules, care, contribution rate, health policy, medical services, social policy, demand, health outcomes, health-care providers, insurance contributions, public providers, income countries, health care financing, decision making, measurement, nutrition, beds, health coverage, social welfare, insurance system, fee-for-service payment, internet, national health, health system, insurance, delivery of health care, physicians, health care delivery, cancer patient, clinics, evaluation, risk, inpatient care, health providers, fee-for- service, demand for health, health insurance contributions, integration, health expenditure, ability to pay, hospital admission, health care expenditure, health insurance funds, sustainable health care, population, hospital beds, health insurance program, public long- term care, strategy, fees, medicines, medicaid, hospitals, implementation, pregnancy, capita health expenditure, provider payment, medical fees, financial incentives, health reform, access to drugs
    Date: 2015–03
  2. By: Krebs, Tom (University of Mannheim); Kuhn, Moritz (University of Bonn); Wright, Mark L. J. (Federal Reserve Bank of Chicago)
    Abstract: We use data from the Survey of Consumer Finance and Survey of Income Program Participation to show that young households with children are under-insured against the risk that an adult member of the household dies. We develop a tractable macroeconomic model with human capital risk, age-dependent returns to human capital investment, and endogenous borrowing constraints due to the limited pledgeability of human capital. We show analytically that, consistent with the life insurance data, in equilibrium young households are borrowing constrained and under-insured. A calibrated version of the model can quantitatively account for the life-cycle variation of life-insurance holdings, financial wealth, earnings, and consumption inequality observed in the US data. Our analysis implies that a reform that makes consumer bankruptcy more costly, like the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005, leads to a substantial increase in the volume of both credit and insurance.
    Keywords: human capital risk, limited enforcement, life insurance
    JEL: E21 E24 D52 J24
    Date: 2015–07
  3. By: Pedro Carneiro (Institute for Fiscal Studies and cemmap and UCL); Rita Ginja (Institute for Fiscal Studies and University of Uppsala)
    Abstract: This paper studies the impact of permanent and transitory shocks to income on parental investments in children. We use panel data on family income, and an index of investments in children in time and goods, from the Children of the National Longitudinal Survey of Youth. Consistent with the literature focusing on non-durable expenditure, we find that there is only partial insurance of parental investments against permanent income shocks, but the magnitude of the estimated responses is small. We cannot reject the hypothesis full insurance against temporary shocks. Another interpretation of our findings is that there is very little insurance available, but the fact that skill is a non-separable function of parental investments over time results in small reactions of these investments to income shocks, especially at later ages.
    Keywords: Insurance; human capital; consumption
    JEL: D12 D91 I30
    Date: 2015–04
  4. By: Dolls, Mathias; Fuest, Clemens; Heinemann, Friedrich; Peichl, Andreas
    Abstract: This contribution develops a blueprint for a European fiscal union. The proposal addresses the shortcomings of most other reform designs which do not offer a solution for insolvent or noncooperative euro countries. We suggest a design which combines fiscal insurance with an orderly procedure to restructure the debt of an insolvent euro member. We show that fiscal insurance and a sovereign insolvency procedure are no contradiction but, on the contrary, mutually enforcing: An effective fiscal insurance helps to limit the stability risks involved in the implementation of an insolvency regime for sovereigns. And vice versa, a well-defined insolvency procedure reduces the danger that a fiscal capacity motivated as an insurance against transitory asymmetric shocks degenerates into a permanent transfer system. Moreover, we show that both elements are a helpful complement for the functioning of the European banking union and the new European fiscal governance.
    Keywords: sovereign insolvency procedure,European unemployment insurance,euro area debt crisis
    JEL: H87 H12
    Date: 2015
  5. By: Brunner, Hans-Peter (Asian Development Bank)
    Abstract: Using panel data regressions, this paper analyzes the effect of imperfections in the formal export credit and insurance market on trade growth in the regions of Africa and Asia. An exclusive comparison of trade performance of the two regions with respect to export credit and insurance is novel in the literature. I employ Berne Union data on export credit insurance for the period 2005 to quarter 1 (Q1) 2012, which is the most extensive dataset of its kind at the moment. As further novelty, I extend the data specification of Auboin and Engemann (2014) to the interaction of export diversification and complexity, intermediated by an agency variable representing the existence of insurance institutions (Export Credit and Investment Guarantee Agency, or ECIGA), with trade growth, and export credit and insurance. The paper can identify a significantly positive effect from the reinforcing interaction of the export credit and insurance market, and export diversity-complexity on trade.
    Keywords: export finance; product market diversification; regional trade growth
    JEL: F13 F36 G14 O16
    Date: 2015–06–01
  6. By: Thomas Buchmueller; John C. Ham; Lara D. Shore-Sheppard
    Abstract: In both its costs and the number of its enrollees, Medicaid is the largest means-tested transfer program in the United States. It is also a fundamental part of the health care system, providing health insurance to low-income families, indigent seniors, disabled adults and, in some states, low-income adults more broadly. This paper reviews the history and structure of the Medicaid program and the large body of economic research that it has spawned in the nearly half century since it was established. We begin by summarizing the program’s history, goals and current rules. We then present program statistics, mainly related to enrollment and expenditures. Finally we turn to the research on the impact of Medicaid on a broad range of outcomes, discussing theoretical and methodological issues important for understanding these effects and reviewing the empirical literature, describing what has been learned thus far, investigating areas where studies seem to reach different conclusions and pointing to areas where we believe additional research would be fruitful.
    JEL: I11 I13 I18 I3
    Date: 2015–07
  7. By: Pedro S. Martins
    Abstract: In most countries, the unemployed are entitled to unemployment benefits only if they have previously worked a minimum period of time. This institutional feature creates a sharp change at eligibility in the disutility from unemployment and may distort the duration of jobs. In this paper, we show that this effect can be evaluated using a regression discontinuity approach. Our evidence is based on longitudinal social security data from Portugal, where the unemployed are required to work a relatively long period to collect benefits. We find that monthly transitions from employment to unemployment increase by 10\% as soon as the eligibility condition is met. This result is driven entirely by transitions to subsidised unemployment, which increase by 20\%, as non-subsidised unemployment is not affected. The effects are even larger for the unemployed with high replacement ratios or those who meet the eligibility condition from multiple employment spells.
    Keywords: Unemployment insurance, Moral hazard, Employment duration, Big data
    JEL: J65 J63
    Date: 2015–08
  8. By: Jonathan Shaw (Institute for Fiscal Studies)
    Abstract: Relatively little is known about the roles that taxes and transfers play in redistributing resources and providing insurance across individuals and across the lifecycle. We embed these alternative roles in a lifecycle model, allowing us to demonstrate what the tax and transfer system achieves from a lifecycle perspective and why it is valuable. We undertake a five-way decomposition of net transfers into a giveaway term and terms corresponding to between- and within-individual redistribution and between- and within-individual insurance. These components are distinguished from perspective of the start of working life, and we consider both the magnitude of net transfers involved and the associated welfare values. Our focus is on females and we also highlight how behavioural responses affect the results. Analysis is conducted for the 2015 UK tax and transfer system relative to a flat-rate baseline, showing what value is provided by the complex tax and welfare entitlement rules in a modern economy. We also consider what is achieved by two important UK benefit reforms--the working families' tax credit (WFTC) reform of 1999 and the universal credit (UC) reform that began in 2013. Our main conclusions are that insurance against wage and family composition shocks is substantial and highly valued by individuals. Within-individual redistribution (i.e. across periods of life) is generally of little value even in the presence of strict borrowing constraints. Behavioural responses tend to increase the size of reform giveaways at the expense of the other components.
    Keywords: tax, insurance, redistribution
    Date: 2014–08
  9. By: USHIRO Fusao
    Abstract: Healthcare and welfare systems can be classified into three broad types: a public model in which services are provided and financed by the government through taxes; a social insurance model in which services are provided by multiple players including private-sector entities with the cost of services financed primarily by insurance premiums; and a free-choice model in which private-sector insurance firms and private-sector service providers fulfill the roles. Under the social insurance model, users are subsidized by public funds collected in the form of mandatory social insurance premiums and can choose from multiple service providers. Therefore, this model is often accompanied by a quasi-market where multiple service providers compete for users (it should be noted, however, that a quasi-market mechanism can also be combined with the tax-financed public model).In Japan, a welfare system close to the public model was established immediately after World War II to provide publicly-funded services through private-sector providers. This system remained the pillar of Japan's welfare system for decades. However, in the course of the fundamental structural reform of the social and welfare system from the 1990s onward, Japan adopted the quasi-market system to introduce competition in various service areas including nursery schools (although they do not fit the exact definition of "quasi-market"), long-term care services for the elderly, and welfare services for the disabled. The Comprehensive Support System for Children and Child-rearing, which was enacted in April 2015, in effect introduced an integrated quasi-market for nursery schools and kindergartens.In fact, however, Japan's prewar healthcare insurance system established under the National Health Insurance Act of 1922 had a de facto quasi-market mechanism.This paper looks at how the quasi-market was adopted and took root as a prototype for Japan's public healthcare services from the historical perspective, and examines the factors and developments that led to the extensive adoption of the quasi-market mechanism in other areas of social and welfare services in the 1990s and thereafter.Furthermore, this paper seeks to clarify the unique characteristics of the quasi-market system that have not been understood consciously so far, and reviews various cases of the quasi-market system that has now become fairly prevalent in Japan by comparing them in a cross-cutting manner, thereby pointing to the need for systematic work to propose measures to improve the institutional design of the current quasi-market system and address problems arising therefrom.
    Date: 2015–05
  10. By: Bartels, Charlotte; Pestel, Nico
    Abstract: Generous income support programs as provided by European welfare states have often been blamed to hamper employment. This paper investigates the importance of incentives inherent in the tax-benefit system for the individual decision to take up work. Using German microdata over the period 1993-2010 we find that recent reforms in Germany increased work incentives at the extensive margin measured by the Participation Tax Rate (PTR), particularly for low-income individuals. Work incentives are even higher if the time horizon is extended to more than one year, pointing at an overestimation of the disincentives by standard measures. Regression analysis reveals that a decrease in the PTR increases the likelihood of taking up work significantly.
    Keywords: labor force participation,work incentives,welfare,unemployment insurance,income taxation
    JEL: H24 H31 J22 J65
    Date: 2015
  11. By: Craig D. Schneider
    Abstract: As part of the Learning Systems for Accountable Care Organizations (ACOs) project, Mathematica developed a web-based, interactive dashboard for Pioneer ACOs.
    Keywords: ACOs, Medicare
    JEL: I
    Date: 2015–07–27
  12. By: Naghmeh Niroomand (Eastern Mediterranean University, North Cyprus); Glenn P. Jenkins (Queen’s University, Canada and Eastern Mediterranean University, North Cyprus)
    Abstract: The incidence of death and injury from automobile accidents in North Cyprus is 3.6 times greater than the average for the EU. With the prospect of North Cyprus entering the EU, many investments will need to be undertaken in order to reduce these figures and reach EU norms. A key task will be to select the investments that are justified on the basis of a cost–benefit or cost–effectiveness analysis and not to waste resources through poor project selection. The objective of this study is to provide local estimates of the value of a statistical life and injury along with the value of time savings. These are among the key parameters needed for the evaluation of the benefits of such projects. In this study we conducted a stated choice experiment to identify the preferences and trade-offs of automobile drivers in North Cyprus for improved travel times, travel costs and safety. The choice of route was examined using mixed logit models to obtain the marginal utilities associated with each attribute of the routes that consumers choose. These estimates were used to assess the individuals’ willingness to pay (WTP) to avoid fatalities and injuries and to save travel time. We then used the results to obtain community-wide estimates of the value of a statistical life (VSL) saved, the value of injury (VI) prevented, and the value per hour of travel time saved.
    Keywords: Willingness to pay; choice experiment; value of risk reduction; value of a statistical life; road safety; car drivers
    JEL: D12 D61 Q50 J17 R41 D12
    Date: 2015–08
  13. By: Charlotte Bartels; Nico Pestel
    Abstract: Generous income support programs as provided by European welfare states have often been blamed to hamper employment. This paper investigates the importance of incentives inherent in the tax-benefit system for the individual decision to take up work. Using German microdata over the period 1993-2010 we find that recent reforms in Germany increased work incentives at the extensive margin measured by the Participation Tax Rate (PTR), particularly for low income individuals. Work incentives are even higher if the time horizon is extended to more than one year, pointing at an overestimation of the disincentives by standard measures. Regression analysis reveals that a decrease in the PTR increases the likelihood of taking up work significantly.
    Keywords: Labor force participation, work incentives, welfare, unemployment insurance, income taxation
    Date: 2015
  14. By: Demary, Markus; Diermeier, Matthias; Haas, Heide
    Abstract: The establishment of a Capital Markets Union (CMU) is a high-priority project of the European Commission. CMU should foster additional non-bank sources of finance, mobilize private savings more efficiently and enhance capital market integration. Although more integration is needed, the Commission's proposal misses the role of systemic functions in a CMU. First, banks are important intermediaries specialized in credit relationships and small and medium-sized companies gain from long-term relationships with banks. Second, overcoming financial fragmentation needs sound sovereign debt markets with stable sovereign finances. In a CMU sovereign risks have to be treated adequately in bank regulation. Third, it should be assessed in advance which sources of non-bank finance will be demanded by companies and will become systemic. We recommend an integrated financial supervision for the CMU. Therefore, the European Banking Union should cover all European Union members' systemic relevant banks. In order to mobilize private savings while coping with the CMU's complexity, the EU should foster financial literacy.
    Abstract: Nachdem die europäische Bankenunion 2014 beschlossen wurde, hat Kommissionspräsident Jean-Claude Juncker nun ein neues Projekt vorgeschlagen, das die Finanzmarktintegration in Europa weiter vorantreiben soll: die Kapitalmarktunion. Während sich die Bankenunion auf die Schaffung eines einheitlichen Regelwerks sowie einer zentralen Bankenaufsicht und -abwicklung für den Bankensektor in der Eurozone beschränkt, soll die Kapitalmarktunion Barrieren aus dem Weg räumen, die den Kapitalfluss in der gesamten Europäischen Union bremsen. Im internationalen Vergleich sind Banken in der EU höchst relevant für die Unternehmensfinanzierung. Im Gegensatz dazu finanzieren sich Unternehmen in den USA stärker direkt über Kapitalmärkte und weniger über Banken. Auch wenn die USA kein explizites Vorbild für die Kapitalmarktunion ist, so zeigt sich doch deutlich, dass eine stärkere Rolle der Kapitalmärkte von der Politik favorisiert wird. [...]
    Keywords: financial aspects of economic integration,financial regulation,investment and savings,relationship-banking,sme finance,Banking and Insurance,European Central Bank,European Monetary Union,Banken und Versicherungen,Europäische Währungsunion,Europäische Zentralbank
    JEL: F02 F33 F36 G21 G28 G30 G38
    Date: 2015

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