nep-ias New Economics Papers
on Insurance Economics
Issue of 2018‒03‒12
ten papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Explaining the Decline in the U.S. Employment-to-Population Ratio: A Review of the Evidence By Katharine G. Abraham; Melissa S. Kearney
  2. Addressing market segmentation and incentives for risk selection: How well does risk equalisation in the Irish private health insurance market work? By Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve
  3. Socio-economic Disparities in U.S. Healthcare Spending: The Role of Public vs. Private Insurance By Elena Capatina; Michael P. Keane; Shiko Maruyama
  4. How Increasing Medical Access to Opioids Contributes to the Opioid Epidemic Evidence from Medicare Part D By David Powell; Rosalie Liccardo Pacula; Erin Audrey Taylor
  5. How States Can Better Understand Their Medicare-Medicaid Enrollees: A Guide to Using CMS Data Resources By Danielle Chelminsky
  6. The parental home as labour market insurance for young Greeks during the crisis By Rebekka Christopoulou, Maria Pantalidou; Maria Pantalidou
  7. How States Can Monitor Dual Eligible Special Needs Plan Performance: A Guide to Using CMS Data Resources By Danielle Chelminsky
  8. Uganda; Technical Assistance Report-Moving Towards Risk-Based Supervision of Insurance in Uganda: Training on Supervision of Reinsurance and Assisting on an Industry Seminar on Risk-Based Supervision By International Monetary Fund
  9. Does Insurance Expansion Alter Health Inequality and Mobility? Evidence from the Mexican Seguro Popular By Joan Costa-i-Font; Frank Cowell; Belén Saénz de Miera Juárez
  10. Analytical Validation Formulas for Best Estimate Calculation in Traditional Life Insurance By Simon Hochgerner; Florian Gach

  1. By: Katharine G. Abraham; Melissa S. Kearney
    Abstract: This paper first documents trends in employment rates and then reviews what is known about the various factors that have been proposed to explain the decline in the overall employment-to-population ratio between 1999 and 2016. Population aging has had a notable effect on the overall employment rate over this period, but within-age-group declines in employment among young and prime age adults have been at least as important. Our review of the evidence leads us to conclude that labor demand factors, in particular trade and the penetration of robots into the labor market, are the most important drivers of observed within-group declines in employment. Labor supply factors, most notably increased participation in disability insurance programs, have played a less important but not inconsequential role. Increases in the real value of the minimum wage and in the share of individuals with prison records also have contributed modestly to the decline in the aggregate employment rate. In addition to these factors, whose effects we roughly quantify, we also identify a set of potentially important factors about which the evidence is too preliminary to draw any clear conclusion. These include improvements in leisure technology, changing social norms, increased drug use, growth in occupational licensing, and the costs and challenges associated with child care. Our evidence-driven ranking of factors should be useful for guiding future discussions about the sources of decline in the aggregate employment-to-population ratio and consequently the likely efficacy of alternative policy approaches to increasing employment rates.
    JEL: J01 J21
    Date: 2018–02
  2. By: Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve
    Date: 2017
  3. By: Elena Capatina (UNSW Sydney); Michael P. Keane (UNSW Sydney); Shiko Maruyama (University of Technology Sydney)
    Abstract: In the US healthcare system, patients of different socio-economic status (SES) often receive disparate treatment for similar conditions. Prior work documents this phenomenon for particular treatments/conditions, but we take a system-wide view and examine socioeconomic disparities in spending for all medical conditions at the 3-digit ICD-9 level. We also compare SES spending gradients for those covered by private vs. public insurance (Medicare). Using data on adult respondents from the Medical Expenditure Panel Survey 2000-14, we estimate multivariate regressions for individual medical spending (total and out-of-pocket) controlling for medical conditions, demographics, health, and insurance, separately by sex, education, and age. Within age-sex categories, we assess how spending on each condition varies with education (a proxy for SES). In the predominantly privately insured population aged 24-64, system spending for several of the most socially costly conditions is strongly increasing in education (e.g., breast cancer for women and chest symptoms for men). These disparities are not explained by differences in health, insurance status, or ability-to-pay, suggesting they arise due to discrimination. However, we find no positive SES gradients for individuals over 64 covered by the public Medicare program, suggesting that Medicare plays an important role in improving equity.
    Keywords: Education gradient, Health insurance systems, Healthcare equity, Private and Public health insurance, Socio-economic disparities
    JEL: I13 I14 I18
    Date: 2018–02
  4. By: David Powell; Rosalie Liccardo Pacula; Erin Audrey Taylor
    Abstract: Drug overdoses involving opioid analgesics have increased dramatically since 1999, representing one of the United States' top public health crises. Opioids have legitimate medical functions, but improving access may increase abuse rates even among those not prescribed the drugs given that opioids are frequently diverted to nonmedical use. We have little evidence about the causal relationship between increased medical access to opioids and spillovers resulting in abuse. We use the introduction of the Medicare Prescription Drug Benefit Program (Part D) as a large and differential shock to the geographic supply of opioids. Part D increased opioid utilization for the 65+ population, and we show that this increase in utilization led to significant growth in the overall supply of opioids in high elderly share states relative to low elderly share states. This relative expansion in opioid supply resulted in an escalation in opioid-related substance abuse treatment admissions and opioid-related mortality among the Medicare-ineligible population, implying meaningful spillovers to individuals who did not experience any change in prescription drug benefits. The evidence suggests that increased opioid supply is associated with economically-important levels of diversion for nonmedical purposes. Our estimates imply that a 10% increase in medical opioid distribution leads to a 7.4% increase in opioid-related deaths and a 14.1% increase in substance abuse treatment admission rates for the Medicare-ineligible population.
    JEL: I11 I12 I13
    Date: 2016–10
  5. By: Danielle Chelminsky
    Abstract: This brief guides readers through the various national and state-level data resources on Medicare-Medicaid enrollees on the CMS website and how to easily use and present the data to stakeholders.
    Keywords: Medicare, Medicaid, enrollment, data, dual eligibles, data visualization, characteristics
    JEL: I
  6. By: Rebekka Christopoulou, Maria Pantalidou; Maria Pantalidou
    Abstract: Labour market conditions in Greece have severely deteriorated during the crisis, affecting youths the most. Using the Greek crisis as a case-study, this paper examines the role of the family as a social safety net for its young members. Specifically, we test the relationship between youth labour outcomes and parental coresidence, whether this relationship has become stronger during the crisis, and the degree to which the relationship is causal. Our results confirm that the parental home is a refuge both for jobless youth and for those in poorly paid, insecure jobs, and this role has intensified during the crisis. We find no reverse causality between co-residence and employment status for young men, and significant reverse causality for women. This finding implies that all youths live in the parental home when they are in need themselves, but it is young women not men who live with parents when parents are in need or for cultural reasons. more research on this subject.
    Keywords: Living arrangements, parental coresidence, youth employment, great recession, Greece
    Date: 2602–10
  7. By: Danielle Chelminsky
    Abstract: This brief guides readers through the various national and state-level data resources on Medicare-Medicaid enrollees in Dual Special Needs Plans (D-SNPs) on the CMS website and how to easily use and present the data to stakeholders.
    Keywords: Medicare, Medicaid, Dual Special Needs Plans, enrollment, data visualization, dual eligibles
    JEL: I
  8. By: International Monetary Fund
    Abstract: This report describes the tasks completed, findings and recommendations of the mission undertaken during the period October 26–November 4, 2015. The mission built further on previous AFE missions and focussed on (i) assisting IRA in building capacity in analyzing and assessing reinsurance (both life and non-life) from both a primary insurer’s and a reinsurer’s perspectives; (ii) providing on-site coaching to the supervisory team at Uganda Reinsurance Company in assessing areas specific to a reinsurer (reinsurance assumed, retrocessions and technical provisions); (iii) participating in an industry workshop to discuss IRA’s move towards risk-based supervision and its implications for IRA and the industry; and (iv) meeting with the IRA Board to discuss essential elements for successful implementation of risk-based supervision as well as recommendations resulting from July 2015 TA report to give the members of the Board a deeper appreciation of what needs to be done for success.
    Keywords: Sub-Saharan Africa;Uganda;
    Date: 2018–01–16
  9. By: Joan Costa-i-Font; Frank Cowell; Belén Saénz de Miera Juárez
    Abstract: The effect of insurance expansions on the distribution of health status is still a matter we know little about. This paper draws upon new measures of pure health inequality and mobility in health which accommodates categorical data to understand how an expansion of public insurance affects both inequality and mobility in health. These measures require a measure of health status that is either “upward-looking” or “downward looking”. We find that, the distribution of health worsens in Mexico between 2002 and 2009, although the change is only consistent for the upward looking definition of status. Together with the lack of mobility in health observed, we can thus conclude that Mexico is becoming more rigid over time insofar as the distribution of health status.
    Keywords: self-reported health, health inequality, health mobility, health insurance, Mexico
    JEL: I18
    Date: 2017
  10. By: Simon Hochgerner; Florian Gach
    Abstract: Within the context of traditional life insurance, a model-independent relationship about how the market value of assets is attributed to the best estimate, the value of in-force business and tax is established. This relationship holds true for any portfolio under run-off assumptions and can be used for the validation of models set up for Solvency~II best estimate calculation. Furthermore, we derive a lower bound for the value of future discretionary benefits. Again, this bound can be used in practice for validation purposes.
    Date: 2018–02

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