nep-ias New Economics Papers
on Insurance Economics
Issue of 2019‒03‒04
25 papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Interactions between Social and Topping Up Insurance under ex-post Moral Hazard By Bell-Aldeghi, Rosalind
  2. Current and Future Sources of Health Insurance Coverage for Alabama Residents By Deborah Chollet; Allison Barrett; Thomas Bell
  3. Amenities, Risk, and Flood Insurance Reform By V. Kerry Smith; Ben Whitmore
  4. Expanding Social Health Protection in Cambodia: An assessment of the current coverage potential and gaps, and social equity considerations By Robert Kolesar; Sambo Pheakdey; Bart Jacobs; Narith Chan; Samedy Yok; Martine Audibert
  5. Alabama's Current Insurance Market By Deborah Chollet; Kate Stewart; Suzie Witmer
  6. Foundation's Consumer Advocacy Health Reform Initiative Strengthened Groups' Effectiveness By Debra Strong; Debra Lipson; Todd Honeycutt; Jung Kim
  7. Estimating Effects of Crop Insurance Enrollment on Farm Input Use By Regmi, Madhav; Briggeman, Brian; Featherstone, Allen
  8. Deposit Insurance, Market Discipline and Bank Risk By Alexei Karas; William Pyle; Koen Schoors
  9. The economic cost of terrorism and natural disasters: A deeper analysis of the financial market markets of Pakistan By Najam, Najam Ul Sabeeh; Mehmood, Arshad Mehmood
  10. Household Responses to Transfers and Liquidity: Evidence from Social Security’s Survivors Benefits By Itzik Fadlon; Shanthi P. Ramnath; Patricia K. Tong
  11. Are Sufficient Statistics Necessary? Nonparametric Measurement of Deadweight Loss from Unemployment Insurance By Lee, David S.; Leung, Pauline; O'Leary, Christopher J.; Pei, Zhuan; Quach, Simon
  12. Labor Market Regulations in the Context of Structural Transformation By Ranjan, Priya; Hasan, Rana; Eleazar, Erik Jan
  13. Optimal Social Insurance and Rising Labor Market Risk By Tom Krebs; Martin Scheffel
  14. Does Crop Insurance Inhibit Climate-Change Irrigation-Technology Adaption? By Sellars, Sarah C.; Thompson, Nathanael M.; Wetzstein, Michael E.; Bowling, Laura C.; Cherkauer, Keith A.; Frankenberger, Jane R.; Prokopy, Linda S.
  15. Adjustment Costs and Incentives to Work: Evidence from a Disability Insurance Program By Zaresani, Arezou
  16. Are Sufficient Statistics Necessary? Nonparametric Measurement of Deadweight Loss from Unemployment Insurance By David S. Lee; Pauline Leung; Christopher J. O'Leary; Zhuan Pei; Simon Quach
  17. The middle class in Japan, 1994-2009: Trends and characteristics By Soichiro Tanaka; Masato Shikata
  18. The main directions of development of the Russian health care system: trends, forks, scenarios By Nazarov, Vladimir (Назаров, Владимир); Avksentiev, Nikolay (Авксентьев, Николай); Sisigina, Natalia (Сисигина, Наталья)
  19. Impacts of the Affordable Care Act on Cigarette Consumption By Wang, Lingxiao; Zheng, Yuqing
  20. Demand for Crash Insurance, Intermediary Constraints, and Risk Premia in Financial Markets By Hui Chen; Scott Joslin; Sophie X. Ni
  21. Timed to Say Goodbye: Does Unemployment Benefit Eligibility Affect Worker Layoffs? By Albanese, Andrea; Ghirelli, Corinna; Picchio, Matteo
  22. How Well Can Medicare Records Identify Seniors with Cognitive Impairment Needing Assistance with Financial Management? By David Weir; Kenneth Langa
  23. Making Outcome-Based Payment a Reality in the NHS By Cole, A.; Cubi-Molla, P.; Pollard, J.; Sim, D, Sullivan, R.; Sussex, J.; Lorgelly, P.
  24. Public Expenditure on Old-Age Income Support in India: Largesse for a Few, Illusory for Most. By Anand, Mukesh Kumar; Chakraborty, Rahul
  25. Farmers’ Preferences on Conditions in Manufacturing Pineapple Sale Contract in Rayong Province By Pichhannaronk, Parkpoom; Daloonpate, Apichart; Sanglestsawai, Santi

  1. By: Bell-Aldeghi, Rosalind
    Abstract: As health expenditure and need for corresponding funding rises, resorting to topping up insurance can seem natural. Complementary and supplementary insurances are both topping up contracts and, as such, are treated as one in the theoretical literature on optimal insurance. We argue that distinguishing them is crucial, and should be considered carefully when defining policies impacting the structure of the health insurance system, as these two kinds of insurance can have opposite effects on social insurance coverage. \indent In this model, the optimal social insurance rate is defined endogenously and varies according to redistribution and the ex-post moral hazard characteristics of the insurance. This game has three stages and is solved through backward induction. The optimal social insurance rate is chosen first, by maximising social welfare. Second, individuals choose their private complementary and supplementary contracts. In the third stage they decide on their level of labour and consumption of health and other goods. \indent Results indicate that whereas the presence of complementary insurance decreases the optimal size of social insurance, the offset effects of supplementary insurance can improve welfare.
    Keywords: Social insurance; health insurance; ex-post moral hazard; topping up; redistribution.
    JEL: D82 I13 I18
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:92417&r=all
  2. By: Deborah Chollet; Allison Barrett; Thomas Bell
    Abstract: This report was prepared for LMI by Mathematica Policy Research to support Alabama’s first-year planning for a Health Insurance Exchange.
    Keywords: Health Insurance Coverage , Alabama , Affordable Care Act , Health, LMI
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:bcdda4abfff24b5a865a30d7bbe291ec&r=all
  3. By: V. Kerry Smith; Ben Whitmore
    Abstract: This paper provides the first, comprehensive evidence on the question of whether the subsidized flood insurance rates are needed to meet the affordability goal of the National Flood Insurance Program. We use IRS records at the zip code level from 2009 to 2016 to compare the real median incomes of homeowners in areas subject to flooding risks to those homeowners in neighboring zip codes. Our analysis includes all of the Gulf Coast states and over 1000 other communities around the United States containing FEMA designated Special Flood Hazard Areas (SFHA). There are clear patterns of positive income stratification for coastal locations in Florida, New Jersey, and New York. We also find lower income for coastal locations in California, North Carolina, as well as the shoreline along rivers identified as in SFHA in Delaware, and Virginia fit this pattern.
    JEL: D31 H2 H84 Q51 Q54
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:25580&r=all
  4. By: Robert Kolesar (The Palladium Group , National Social Protection Council, Ministry of Economy and Finance, CERDI - Centre d'Études et de Recherches sur le Développement International - Clermont Auvergne - UCA - Université Clermont Auvergne - CNRS - Centre National de la Recherche Scientifique); Sambo Pheakdey (National Social Protection Council, Ministry of Economy and Finance); Bart Jacobs (Radboud university [Nijmegen], GIZ - Deutsche Gesellschaft für Internationale Zusammenarbeit); Narith Chan (National Social Protection Council, Ministry of Economy and Finance); Samedy Yok (National Social Protection Council, Ministry of Economy and Finance); Martine Audibert (CERDI - Centre d'Études et de Recherches sur le Développement International - Clermont Auvergne - UCA - Université Clermont Auvergne - CNRS - Centre National de la Recherche Scientifique)
    Abstract: The Government of Cambodia recently launched its National Social Protection Policy Framework to strengthen and expand its social protection system. To inform the future direction of social health protection policy in Cambodia we examine the 2016 Cambodia Socio-economic survey to assess the current coverage potential of existing health insurance schemes and coverage gaps; and, compare fair and equitable contribution rates. The current health coverage expansion efforts are likely to primarily benefit individuals from higher income households. In addition, recent directives to expand coverage to some informal workers leaves significant gaps, particularly among vulnerable groups, farmers, and the self-employed. The average out-of-pocket health care costs exceed capacity to pay among individuals in the lower wealth quintiles. Thus, we conclude they should be considered financially vulnerable. Finally, we illustrate that a fair and equitable approach to individual, monthly healthcare contributions will yield low premium rates and collection costs could exceed the amount collected, particularly among the informal sector. Therefore, we recommend that, in addition to other vulnerable groups and uncovered households in the first wealth quintile, people second and third quintiles who are not formally employed, should be exempted from premium payments as social health protection is expanded.
    Keywords: Social protection policy,Universal health care,Cambodia,Social equity,Vulnerability.
    Date: 2019–02–14
    URL: http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-02018867&r=all
  5. By: Deborah Chollet; Kate Stewart; Suzie Witmer
    Abstract: This report, prepared by Mathematica Policy Research through subcontract with LMI, offers policymakers a picture of the insurance market for individuals and small groups in Alabama in 2010, and a summary of market change over the prior 5 years as reported by selected carriers.
    Keywords: Alabama Insurance Market , ACA , LMI
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:6c80c14fbcaf405dad54904b782a48ad&r=all
  6. By: Debra Strong; Debra Lipson; Todd Honeycutt; Jung Kim
    Abstract: This article in the GrantWatch section of Health Affairs describes the evaluation of Consumer Voices for Coverage, a state-based advocacy program to expand and improve health insurance coverage.
    Keywords: Foundations Consumer Advocacy , Health Reform
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:8bca499798fe4d13a160d1591b799694&r=all
  7. By: Regmi, Madhav; Briggeman, Brian; Featherstone, Allen
    Keywords: Agricultural Finance, Farm Management, Agricultural and Food Policy, Production Economics, Risk & Uncertainty
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:ags:saea19:284310&r=all
  8. By: Alexei Karas; William Pyle; Koen Schoors (-)
    Abstract: Using evidence from Russia, we explore the e ect of the introduction of deposit insurance on bank risk. Drawing on within-bank variation in the ratio of firm deposits to total household and firm deposits, so as to capture the magnitude of the decrease in market discipline after the introduction of deposit insurance, we demonstrate for private, domestic banks that larger declines in market discipline generate larger increases in traditional measures of risk. These results hold in a di erence-in-di erence setting in which state and foreign-owned banks, whose deposit insurance regime does not change, serve as a control..
    Keywords: deposit insurance, market discipline, moral hazard, risk taking, banks, Russia
    JEL: E65 G21 G28 P34
    Date: 2019–01
    URL: http://d.repec.org/n?u=RePEc:rug:rugwps:19/953&r=all
  9. By: Najam, Najam Ul Sabeeh; Mehmood, Arshad Mehmood
    Abstract: Do natural disasters and terrorism affect the financial markets of Pakistan? We aimed to answer this question by studying a large dataset of stock returns of financial markets of Pakistan with respect to natural disasters and terrorist activities. The dataset consists of a total of 289 terrorist events and 45 natural disasters; taken from the Global Terrorism Database (GTD) and Emergency Database (EM-DAT), covering events from the year 2003 to 2017. The event study methodology used to analyze daily, weekly and monthly stock returns of concerned sectors. Calculated the Abnormal returns with the help of market adjusted return model. The findings show that terrorist events have a statistically significant negative impact on the banking sector returns as well as insurance sector returns. Furthermore, the impact on the Pakistan Stock Market is insignificant. The impact of natural disasters on stock markets was not significant however when studied separately the floods have a negative significant impact on bank returns while insignificant for insurance and stock market returns. On the other hand, earthquakes are negatively affecting the stock market but no impact has been reported significant neither for insurance nor for banks returns.
    Keywords: Terrorism, Natural Disasters, Stock Market, Financial Sectors, Event Study Methodology, Market Adjusted Returns Model
    JEL: G21 O16
    Date: 2019–01–18
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:92278&r=all
  10. By: Itzik Fadlon; Shanthi P. Ramnath; Patricia K. Tong
    Abstract: We use administrative tax data that cover the U.S. population to identify the causal effects of Social Security’s survivors benefit receipt on American families’ behavior and financial well-being. We analyze over a quarter of a million widowed households in which the husband died between 2002-2007, and we exploit a sharp age discontinuity in benefit eligibility to study the responses of financially vulnerable households to government transfers. We first study how households respond to unanticipated benefit receipt in the immediate periods following a large financial shock to investigate the protective role of transfers. We find significant impacts of the program on newly-widowed families’ net income and labor supply behavior, which points to considerable allocative inefficiencies in the life insurance market and to a high valuation of survivors benefits in protecting Americans against mortality shocks. Second, to investigate the particular role of liquidity and benefit timing, we then study how already-widowed women’s labor supply responds to anticipated survivors benefit receipt. We find considerable responses to cash-on-hand via benefit availability that underscore allocative inefficiencies in the credit market and the value of liquidity itself provided by government transfers. These responses and their heterogeneity highlight mechanisms that underlie the labor supply behavior of older vulnerable households, and they point to liquidity constraints, rather than myopia or benefit-schedule misperceptions, as the likely operative channel. Our results have implications for survivors benefits in the U.S., and, more generally, for retirement behavior and response mechanisms to transfers among older vulnerable populations.
    JEL: D1 D61 G22 H0 H55 I1 I38 J2
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:25586&r=all
  11. By: Lee, David S. (Princeton University); Leung, Pauline (Cornell University); O'Leary, Christopher J. (Upjohn Institute for Employment Research); Pei, Zhuan (Cornell University); Quach, Simon (Princeton University)
    Abstract: Central to the welfare analysis of income transfer programs is the deadweight loss associated with possible reforms. To aid analytical tractability, its measurement typically requires specifying a simplified model of behavior. We employ a complementary "decomposition" approach that compares the behavioral and mechanical components of a policy's total impact on the government budget to study the deadweight loss of two unemployment insurance policies. Experimental and quasi-experimental estimates using state administrative data show that increasing the weekly benefit is more efficient (with a fiscal externality of 53 cents per dollar of mechanical transferred income) than reducing the program's implicit earnings tax.
    Keywords: behavioral and mechanical effects, decomposition, sufficient statistics, optimal unemployment insurance, partial unemployment insurance, unemployment insurance, regression kink design, deadweight loss, fiscal externality
    JEL: C14 C20 C31 H2 H23 J64 J65 J68
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp12154&r=all
  12. By: Ranjan, Priya (University of California, Irvine); Hasan, Rana (Asian Development Bank); Eleazar, Erik Jan (Asian Development Bank)
    Abstract: This paper constructs a theoretical model to study labor market regulations in developing countries within the context of structural transformation. When workers are risk averse and the market for insurance against labor income risk is missing, regulations that provide insurance to workers (such as severance payments) are efficiency enhancing and promote structural transformation. However, regulations that simply create barriers to the dismissal of workers not only impede structural transformation, they also end up reducing the welfare of workers. The implications of some other issues like general regulatory burden, weak state capacity, and minimum wage regulations are analyzed as well. The paper provides some empirical evidence broadly consistent with the theoretical results using cross-country data. While dismissal regulations increase the share of informal employment, severance payments to workers do not.
    Keywords: dismissal regulations; informal employment; minimum wage; severance payments; structural transformation
    JEL: J38 O12 O17 O57
    Date: 2018–04–16
    URL: http://d.repec.org/n?u=RePEc:ris:adbewp:0543&r=all
  13. By: Tom Krebs (Universitat Mannheim); Martin Scheffel (Karlsruhe Institute of Technology)
    Abstract: This paper analyzes the optimal response of the social insurance system to a rise in labor market risk. To this end, we develop a tractable macroeconomic model with risk-free physical capital, risky human capital (labor market risk) and unobservable effort choice affecting the distribution of human capital shocks (moral hazard). We show that constrained optimal allocations are simple in the sense that they can be found by solving a static social planner problem. We further show that constrained optimal allocations are the equilibrium allocations of a market economy in which the government uses taxes and transfers that are linear in household wealth/income. We use the tractability result to show that an increase in labor market (human capital) risk increases social welfare if the government adjusts the tax-and-transfer system optimally. Finally, we provide a quantitative analysis of the secular rise in job displacement risk in the US and find that the welfare cost of not adjusting the social insurance system optimally can be substantial.
    Keywords: labor market risk, social insurance, moral hazard
    JEL: E21 H21 J24
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:hka:wpaper:2019-012&r=all
  14. By: Sellars, Sarah C.; Thompson, Nathanael M.; Wetzstein, Michael E.; Bowling, Laura C.; Cherkauer, Keith A.; Frankenberger, Jane R.; Prokopy, Linda S.
    Keywords: Agricultural Finance, Farm Management, Environmental Economics and Policy
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:ags:saea19:284271&r=all
  15. By: Zaresani, Arezou (Melbourne Institute of Applied Economic and Social Research)
    Abstract: How important are adjustment costs for individuals when they face a change in work incentives induced by a policy change? I provide the first estimate of heterogeneous adjustment costs by exploiting a policy change that substantially increased work incentives. The policy change increased the exemption threshold in a disability insurance program. I document strong responses to work incentives as I observe excess mass –"bunching"– right below the exemption threshold where the marginal tax on earnings is low. A puzzling observation is that individuals continue bunching at the former threshold after the policy change. This finding suggests that they face adjustment costs when changing their labor supply. I use the amount of bunching at the new and former threshold to estimate adjustment costs that vary by individuals' ability to work. The estimated adjustment costs are higher for individuals with lower ability; varying from zero to twenty percent of their potential earnings, with an average at eight percent. The estimated elasticity of earnings respect to net-of-tax rate – accounting for heterogeneous adjustment costs – is 0.2, which is double the size of the elasticity estimated with no adjustment costs. To investigate the relative size of the adjustment costs to the work incentives induced by the policy change, I evaluate the overall effect of the policy change on the labor supply using a Difference-in-Differences design. I find that individuals who already work, work more, and those who did not work, start working. Policies designed to increase labor supply will work if the induced work incentives are large enough to offset the adjustment costs. Accounting for adjustment costs then might explain disparate findings on the effects of an increase in work incentives on labor supply in disability insurance programs. These findings have important implications for designing policies and targeting heterogeneous groups to increase labor supply in disability insurance programs.
    Keywords: adjustment costs, bunching, kink, elasticity, disability insurance
    JEL: H53 J21 J18
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp12136&r=all
  16. By: David S. Lee; Pauline Leung; Christopher J. O'Leary; Zhuan Pei; Simon Quach
    Abstract: Central to the welfare analysis of income transfer programs is the deadweight loss associated with possible reforms. To aid analytical tractability, its measurement typically requires specifying a simplified model of behavior. We employ a complementary “decomposition” approach that compares the behavioral and mechanical components of a policy’s total impact on the government budget to study the deadweight loss of two unemployment insurance policies. Experimental and quasi-experimental estimates using state administrative data show that increasing the weekly benefit is more efficient (with a fiscal externality of 53 cents per dollar of mechanical transferred income) than reducing the program’s implicit earnings tax.
    JEL: C14 C20 C31 H2 H23 J64 J65 J68
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:25574&r=all
  17. By: Soichiro Tanaka (Department of Economics, Kanto Gakuin University); Masato Shikata (School of policy studies, Kwansei Gakuin University)
    Abstract: In this study, we estimate the population shares of the Japanese middle class during 1994-2009 and discuss its characteristics. The middle class hovered around 65% (from 67.29% in 1994 to 65.21% in 2009) of the population, having 75-200% of each year's median income. However, if we fix the income ranges of the middle class to the 1994 level, the middle class declined considerably to 59.47% in 2009, the upper class also declined, and the lower class and the poor increased. Thus, the stability of the middle class seems due to the overall decline in Japan's income distribution. In addition, the population share of the middle class among the working population (18-64 years) is larger than that among the elderly population (65 years and over). Therefore, the middle class is in danger of shrinking further as the population continues ageing. Meanwhile, population ageing also affects redistributive policies: the share of social transfers of gross income is increasing and the redistributive effect of social security is growing. Additionally, despite declining income levels, there were no major changes in the share of income tax (including social insurance premiums) on gross income. This is, in fact, assumed to be due to factors such as increased social insurance rates.
    Keywords: Middle class, Income inequality, Poverty rate
    JEL: D31 H24 I32
    Date: 2019–01–07
    URL: http://d.repec.org/n?u=RePEc:keo:dpaper:2019-001&r=all
  18. By: Nazarov, Vladimir (Назаров, Владимир) (The Russian Presidential Academy of National Economy and Public Administration); Avksentiev, Nikolay (Авксентьев, Николай) (The Russian Presidential Academy of National Economy and Public Administration); Sisigina, Natalia (Сисигина, Наталья) (The Russian Presidential Academy of National Economy and Public Administration)
    Abstract: The report examines the most acute and actual problems of the Russian health care system, among which are the challenges characteristic of most developed countries in the period of the emergence of public health, structural problems inherent in national health care for many years, as well as new challenges related to the need to introduce innovative medical technologies. On the basis of international experience in solving comparable problems, an analysis of the goals and objectives of the state policy in the field of health care, set by Decree of the President of the Russian Federation of May 7, 2018 No. 204, is carried out.
    Date: 2019–01
    URL: http://d.repec.org/n?u=RePEc:rnp:ppaper:021916&r=all
  19. By: Wang, Lingxiao; Zheng, Yuqing
    Keywords: Marketing, Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:ags:saea19:284284&r=all
  20. By: Hui Chen; Scott Joslin; Sophie X. Ni
    Abstract: We propose a new measure of financial intermediary constraints based on how the intermediaries manage their tail risk exposures. Using data for the trading activities in the market of deep out-of-the-money S&P 500 put options, we identify periods when the variations in the net amount of trading between financial intermediaries and public investors are likely to be mainly driven by shocks to intermediary constraints. We then infer tightness of intermediary constraints from the quantities of option trading during such periods. A tightening of intermediary constraint according to our measure is associated with increasing option expensiveness, higher risk premia for a wide range of financial assets, deterioration in funding liquidity, and broker-dealer deleveraging.
    JEL: G01 G12 G17 G2
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:25573&r=all
  21. By: Albanese, Andrea; Ghirelli, Corinna; Picchio, Matteo
    Abstract: We study how unemployment benefit eligibility affects the layoff exit rate by exploiting quasi-experimental variation in eligibility rules in Italy. By using a difference-indifferences estimator, we find an instantaneous increase of about 12% in the layoff probability when unemployment benefit eligibility is attained, which persists for about 16 weeks. These findings are robust to different identifying assumptions and are mostly driven by jobs started after the onset of the Great Recession, in the South and for small firms. We argue that the moral hazard from the employer’s side is the main force driving these layoffs.
    Keywords: Unemployment insurance,layoffs,employer–employee moral hazard,difference-in-differences,heterogeneous effects
    JEL: C31 C41 J21 J63 J65
    Date: 2019
    URL: http://d.repec.org/n?u=RePEc:zbw:glodps:323&r=all
  22. By: David Weir (University of Michigan); Kenneth Langa (University of Michigan)
    Abstract: Aging countries should have an interest in policies to assist older beneficiaries in managing finances when there is a need. This project investigated the value of Medicare records as a guide to identifying persons with cognitive impairment in need of assistance with financial management. It used data from the Health and Retirement Study (HRS) on persons 65 and older, who consented to linkage to Medicare records at a rate of approximately 90 percent. Sampling weights were adjusted to account for linkage rates. The HRS survey data provided direct evidence on cognitive impairment and difficulty managing finances. The Medicare records are an imperfect guide to cognitive impairment as a medical diagnosis. About 40 percent of persons with impairment consistent with dementia are not identified in Medicare, and about 40 percent of persons with a diagnosis in Medicare records do not have impairment that severe. The records are even worse as a guide to who perceives or is perceived by others as needing assistance with financial management. Outside of institutional settings, Medicare records identify fewer than half the people needing assistance with financial management, and point to a substantial number of people who say they do not. The use of Medicare records alone to identify older beneficiaries in need of assistance with financial management would lead to substantial errors in coverage.
    Date: 2018–10
    URL: http://d.repec.org/n?u=RePEc:mrr:papers:wp391&r=all
  23. By: Cole, A.; Cubi-Molla, P.; Pollard, J.; Sim, D, Sullivan, R.; Sussex, J.; Lorgelly, P.
    Abstract: OHE Research Paper 19/01 - This report explores the feasibility of introducing one type of flexible payment mechanism –outcome-based payment (OBP) –for cancer medicines into the NHS in England. This model links the price the NHS pays for a medicine to the outcomes it achieves in practice for NHS patients. OBP could help to accelerate patient access to some new medicines and ensure close monitoring of real-world patient benefit. It can also promote value for money in NHS spending and support innovation. This is especially valuable against the backdrop of rising overall NHS spending on medicines. The findings in this report are based on both qualitative and quantitative analysis, using a combination of literature reviews, interviews with key stakeholders, and engagement with patients and carers through focus groups and a survey. This report is the result of a research grant awarded to The Office of Health Economics and RAND Europe in collaboration with King's College London in 2018, by Cancer Research UK and Greater Manchester Health and Social Care Partnership (GMHSCP). Please cite this report as - Cole, A., Cubi-Molla, P., Pollard, J., Sim, D., Sullivan, R., Sussex, J. and Lorgelly, P., 2019. Making Outcome-Based Payment a Reality in the NHS. OHE, RAND Europe, KCL and Cancer Research UK Research Paper. Available at - https://www.ohe.org/publications/making- outcome-based-payment-reality-nhs
    Keywords: Judging value for money and improving decision making; Measuring and valuing outcomes
    JEL: I1
    Date: 2019–02–01
    URL: http://d.repec.org/n?u=RePEc:ohe:respap:002115&r=all
  24. By: Anand, Mukesh Kumar (National Institute of Public Finance and Policy); Chakraborty, Rahul (National Institute of Public Finance and Policy)
    Abstract: Policy enunciation often remains hostage to a program-centric approach for plan-ning and reform in developing countries. Old-age income support in India faces such a policy predicament. Extant studies deciphering related public expenditure thus carry lim-itations on (a) system expanse, (b) corresponding data collation, and therefore (c) depth of resource conscription. Benchmarking to the five-pillar architecture advanced by World Bank for old-age income support system, this paper traces (a) public expenditure, (b) av-erage benefits, (c) workers included, and (d) elderly covered, under each pillar in India. The constituents for respective pillars in India are heuristically identified and data on expenditure by federal and sub-national governments are collated or estimated using government finance accounts and annual reports. Workers and elderly covered under each pillar are estimated using data drawn from diverse sources on identifiable groups. The study finds that, the extant system in India presents a larger and rising burden on sub-national governments, with implications for macroeconomic balance. In 2013-4 the elderly comprised 8.6 percent of the population and old-age income support system entailed 11.5 percent of public expenditure of combined federal and sub-national govern-ments. Less than two percent of it constituted co-contributions in the nature of capital expenditure. Only 43 percent of 118.36 million elderly drew benefit from public expendi-ture and more than 85 percent workers remain excluded from the system. Including those drawing social pension, 70 percent of all beneficiaries collect less than the rural poverty line drawn at INR 11016 per annum. The paper suggests (a) capping defined-benefit for exceptionally privileged, (b) re-form of regulatory paradigm to harmonize contributory schemes, dissolve exclusive (sec-tion, sector, or region-based) approach and adopt inclusive principle to widen coverage, (c) unrequited sustained contribution by government for low-income earners and under-privileged, and (d) assimilation of information technology enablers for effective and effi-cient targeting of social pension. Pension policy reform anywhere, often faces arduous implementation, and extant processes in India merely tinker with inception of an essentially long gestation procedure.
    Keywords: Pension in Developing Countries ; Public Expenditure ; Social Security System in India
    JEL: H55 J14
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:npf:wpaper:19/253&r=all
  25. By: Pichhannaronk, Parkpoom; Daloonpate, Apichart; Sanglestsawai, Santi
    Abstract: This paper aimed to evaluate farmers’ preferences on condition attributes in a manufacturing pineapple sale contract. Data were collected from 300 pineapple farmers in Rayong province in the cropping season 2015 using paper-based questionnaires. Conjoint analysis model was employed to analyze the attribute ranking. Consequently, farmers were grouped by using cluster analysis in order to study attribute ranking for each group. The analytical results revealed that farmers’ preferences were affected respectively by coverage-crop insurance option, price option, contract quantity and input supply arrangement. Finally, the attribute set that was found to obtain the highest total utility included guaranteed minimum prices, total quantity purchase and partial coverage-crop insurance. The farmers were segmented in 2 groups due to their preferences. The first group of farmers mostly had their planted areas between 20-40 rais and attended at least one training program concerning agricultural knowledge. The most important attribute of the first group was coverage-crop insurance option. Most of the second-group farmers had a small area planted and never attended the training. The price option was the most importance attribute for the second group. The suggestion from this study was that farmers, pineapple manufacturers and related government sectors jointly set a reasonably minimum guaranteed price that is consistent to the cost of production. Moreover, coverage-crop insurance could be added in a manufacturing pineapple sale contact in order to increase the farmers' confidence in their production.
    Keywords: Institutional and Behavioral Economics
    Date: 2017–02–28
    URL: http://d.repec.org/n?u=RePEc:ags:kuaewp:284120&r=all

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