nep-ias New Economics Papers
on Insurance Economics
Issue of 2015‒10‒10
ten papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Equilibrium in insurance markets with adverse selection when insurers pay policy dividends By Pierre Picard
  3. Social long-term care insurance with two-sided altruism By Cremer, Helmuth; Pestieau, Pierre; Roeder, Kerstin
  4. Long-term care reform and the labor supply of household members: Evidence from a quasi-experiment By Geyer, Johannes; Korfhage, Thorben
  5. Labor Supply Responses to New Rural Social Pension Insurance in China: A Regression Discontinuity Approach By Chen, Zeyuan; Bengtsson, Tommy; Helgertz, Jonas
  6. "Cult of equity": actuaries and the transformation of pension fund investing, 1948–1960 By Yally Avrahampour
  7. Report to Congress: The Centers for Medicare & Medicaid Services' Evaluation of For-Profit PACE Programs Under Section 4804(b) of the Balanced Act of 1997 By David Jones
  8. Competitive Grant-Making: Lessons for Funders to Help Local Governments Increase Health Coverage By Cara Orfield; Sheila Hoag; Debra Lipson
  9. The Financial Support for Long-Term Elderly Care and Household Savings Behaviour By Asako OHINATA; Matteo PICCHIO
  10. Association Between the Medicare Hospice Benefit and Health Care Utilization and Costs for Patients With Poor-Prognosis Cancer By Obermeyer, Ziad; Makar, Maggie; Abujaber, Samer; Dominici, Francesca; Block, Susan Dale; Cutler, David M.

  1. By: Pierre Picard (Département économie - Ecole Polytechique)
    Abstract: We show that an equilibrium always exists in the Rothschild-Stiglitz insurance market model with adverse selection and an arbitrary number of risk types, when insurance contracts include policy dividend rules. The Miyazaki-WilsonSpence state-contingent allocation is an equilibrium allocation, and it is the only one when out-of-equilibrium beliefs satisfy a robustness criterion. It is shown that stock insurers and mutuals may coexist, with stock insurers o⁄ering insurance coverage at actuarial price and mutuals cross-subsidizing risks.
    Keywords: Participating Contract, Policy Dividend.,Insurance, Adverse Selection, Mutual
    Date: 2015–09–01
  2. By: Hakki Ciftci (Cukurova University); Erhan Iscan (Cukurova University); Duygu Serin (Cukurova University)
    Abstract: The insurance sector has great importance for modern society. Insurance sector is one of the most important financial institutions in the financial system that affects the economic growth with the remarkable assets. Especially since the 1950s, the insurance sector has high growth rates. From the end of the 19th century, effects of the financial institutions on economic growth are studied in-depth in the literature. The results of many studies showed that impact of financial institutions on economic growth is significant. However, the literature on the role of the insurance sector on economic growth in comparison with the role of the banks on economic growth has not been studied very much. The main objective of this study is to investigate the interaction between the Turkish insurance sector and economic growth. In this study, the development of the Turkish insurance sector and influence of insurance sector on economic growth will be studied. Afterwards using the methods of time series analysis, the interaction between the size of the Turkish insurance sector and economic growth will be investigated. Findings from the study will provide us important information about the details of the interaction between insurance sector and economic growth. Basic contribution of this work is to provide useful information about the details of this interaction to policy-makers and agents for effective decision-making. Further analysis of this interaction will emphasize the importance of the insurance sector for economic growth.
    Keywords: Insurance, Economic Growth, Insurance Premium, Turkish Insurance Sector
    JEL: C32 G22 O43
  3. By: Cremer, Helmuth; Pestieau, Pierre; Roeder, Kerstin
    Abstract: This paper studies the design of a social long-term care (LTC) insurance when altruism is two-sided. The laissez-faire solution is not efficient, unless there is perfect altruism. Under full information, the rst-best can be decentralized by a linear subsidy on informal aid, a linear tax on bequests when the parent is dependent and state specic lump-sum transfers which provide insurance. We also study a second-best scheme comprising a LTC benet, a payroll tax on childrens earnings and an inheritance tax. This scheme redistributes resources across individuals and between the states of nature and the tax on childrens labor enhances informal care to compensate for the childrens possible less than full altruism.
    Keywords: Long-term care, Two-sided altruism
    JEL: H2 H5
    Date: 2015–07
  4. By: Geyer, Johannes; Korfhage, Thorben
    Abstract: Germany introduced a new mandatory insurance for long-term care in 1995 as part of its social security system. It replaced a system based on means tested social welfare. Benefits from the long-term care insurance are not means tested and depend on the required level of care. The insurance provides both benefits in kind and cash benefits. The new scheme improved the situation for households to organize informal care at home. This was one goal of the reform since policymakers view informal care as a cost-saving alternative to formal care. This view however neglects possible opportunity costs of reduced labor supply of carers. We exploit this reform as a quasi-experiment and examine its effect on the labor supply of caregivers who live in the same household as the care recipient. We find strong negative labor market effects for men but not for women. We conduct a series of robustness tests and find results to be stable.
    Abstract: Im Jahr 1995 wurde in Deutschland eine neue Pflegeversicherung eingeführt. Als Pflichtversicherung ist sie eine eigenständige Säule der Sozialversicherung und ersetzte ein System der einkommensabhängigen Sozialhilfe. Leistungen der neuen Pflegeversicherung werden durch den Grad der Pflegebedürftigkeit bestimmt und sind einkommensunabhängig. Da anspruchsberechtigte Pflegebedürftige zwischen Geld- und Sachleistungen wählen können, wurde die Situation von Haushalten, die häusliche, informelle Pflege organisieren müssen verbessert. Die informelle Pflege zu stärken war eines der wichtigsten Ziele der Pflegereform, da sie häufig als die kostengünstige Alternative im Vergleich zu formellen Pflege wahrgenommen wird. Diese Sichtweise ignoriert jedoch Opportunitätskosten, die entstehen, wenn Pflegende ihr Arbeitsangebot reduzieren, um die Doppelbelastung aus Pflege und Lohnarbeit abzuschwächen. Wir nutzen die Reform als Quasi-Experiment und untersuchen ihren Einfluss auf das Arbeitsangebot von Pflegenden, die mit einer pflegebedürftigen Person in einem Haushalt wohnen. Wir finden starke negative Arbeitsangebotseffekte für Männer, jedoch keine Effekte für Frauen.
    Keywords: labor supply,long-term care,long-term care insurance,natural experiment,quasi-experiment
    JEL: J22 H31 I13
    Date: 2015
  5. By: Chen, Zeyuan (Lund University); Bengtsson, Tommy (Lund University); Helgertz, Jonas (Lund University)
    Abstract: Transitioning into retirement is an under-researched phenomenon in developing countries. Largely, this is linked to a predominance of contexts where – in particular – the rural population remains outside the coverage of any formal pension system. In 2008, China introduced the New Rural Social Pension (NRSP), a program which by now covers the majority of the Chinese rural elderly. This paper examines the effects of the NRSP on the labor supply of the elderly in rural China. As pension benefit eligibility at the time of its implementation is conditional on age, a regression discontinuity design is applied to investigate the casual effect of the receipt of pension benefits on labor supply. Furthermore, as the NRSP is neither means-tested nor conditions on retirement, it induces a pure income effect on employment. Using data from the China Health and Retirement Longitudinal Study, a nationally representative data set, we find that the receipt of pension benefits increases the probability of retirement among the rural elderly by around 15%.
    Keywords: China, New Rural Social Pension, labor supply, regression discontinuity, retirement
    JEL: H55 J26
    Date: 2015–09
  6. By: Yally Avrahampour
    Abstract: This article examines the mid-twentieth-century transformation of U.K. pension fund investment policy known as the “cult of equity.” It focuses on the influence exercised by the Association of Superannuation and Pension Funds over actuarial and corporate governance standards, through actuaries who were members of its council. This intervention led to increasingly permissive actuarial valuations that reduced contributions for sponsors of pension funds investing in equities. Increased demand for equities required pension funds to adopt a more permissive approach to corporate governance than insurance companies and investment trusts, and contributed to declining standards of corporate governance.
    JEL: E6
    Date: 2015
  7. By: David Jones
    Abstract: Summary for publication Report to Congress The Centers for Medicare Medicaid Services Evaluation of ForProfit PACE Programs
    Keywords: PACE, Report to Congress
    JEL: I
    Date: 2015–05–19
  8. By: Cara Orfield; Sheila Hoag; Debra Lipson
    Keywords: Competitive Grant Making, Local Governments, Health Coverage
    JEL: I
    Date: 2015–05–20
  9. By: Asako OHINATA (University of Leicester, UK, Department of Economics); Matteo PICCHIO (Universit… Politecnica delle Marche, Dipartimento di Scienze Economiche e Sociali)
    Keywords: Long-term elderly care, ageing, difference-in-difference, means tested financial support, saving, wealth
    JEL: C21 D14 I18 J14
    Date: 2015–09
  10. By: Obermeyer, Ziad; Makar, Maggie; Abujaber, Samer; Dominici, Francesca; Block, Susan Dale; Cutler, David M.
    Abstract: Importance More patients with cancer use hospice currently than ever before, but there are indications that care intensity outside of hospice is increasing, and length of hospice stay decreasing. Uncertainties regarding how hospice affects health care utilization and costs have hampered efforts to promote it. Objective To compare utilization and costs of health care for patients with poor-prognosis cancers enrolled in hospice vs similar patients without hospice care. Design, Setting, and Participants Matched cohort study of patients in hospice and nonhospice care using a nationally representative 20% sample of Medicare fee-for-service beneficiaries who died in 2011. Patients with poor-prognosis cancers (eg, brain, pancreatic, metastatic malignancies) enrolled in hospice before death were matched to similar patients who died without hospice care. Exposures Period between hospice enrollment and death for hospice beneficiaries, and the equivalent period of nonhospice care before death for matched nonhospice patients. Main Outcomes and Measures Health care utilization including hospitalizations and procedures, place of death, cost trajectories before and after hospice start, and cumulative costs, all during the last year of life. Results Among 86 851 patients with poor-prognosis cancers, median time from first poor-prognosis diagnosis to death was 13 months (interquartile range [IQR], 3-34), and 51 924 patients (60%) entered hospice before death. Matching yielded a cohort balanced on age, sex, region, time from poor-prognosis diagnosis to death, and baseline care utilization, with 18 165 patients in the hospice group and 18 165 in the nonhospice group. After matching, 11% of nonhospice and 1% of hospice beneficiaries who had cancer-directed therapy after exposure were excluded. Median hospice duration was 11 days. After exposure, nonhospice beneficiaries had significantly more hospitalizations (65% [95% CI, 64%-66%], vs hospice with 42% [95% CI, 42%-43%]; risk ratio, 1.5 [95% CI, 1.5-1.6]), intensive care (36% [95% CI, 35%-37%], vs hospice with 15% [95% CI, 14%-15%]; risk ratio, 2.4 [95% CI, 2.3-2.5]), and invasive procedures (51% [95% CI, 50%-52%], vs hospice with 27% [95% CI, 26%-27%]; risk ratio, 1.9 [95% CI, 1.9-2.0]), largely for acute conditions not directly related to cancer; and 74% (95% CI, 74%-75%) of nonhospice beneficiaries died in hospitals and nursing facilities compared with 14% (95% CI, 14%-15%) of hospice beneficiaries. Costs for hospice and nonhospice beneficiaries were not significantly different at baseline, but diverged after hospice start. Total costs over the last year of life were $71 517 (95% CI, $70 543-72 490) for nonhospice and $62 819 (95% CI, $62 082-63 557) for hospice, a statistically significant difference of $8697 (95% CI, $7560-$9835). Conclusions and Relevance In this sample of Medicare fee-for-service beneficiaries with poor-prognosis cancer, those receiving hospice care vs not (control), had significantly lower rates of hospitalization, intensive care unit admission, and invasive procedures at the end of life, along with significantly lower total costs during the last year of life.
    Date: 2014

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