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on Insurance Economics |
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Issue of 2019‒04‒01
twenty-two papers chosen by Soumitra K. Mallick Indian Institute of Social Welfare and Business Management |
| By: | Margaret S. Colby; Debra J. Lipson; Sarah R. Turchin |
| Abstract: | This article examines the relationship between total state Medicaid spending per child and measures of insurance adequacy and access to care for publicly insured children. |
| Keywords: | Medicaid , Health Care Expenditures , Health care access , Value |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d3a7c57b095b40e5bd8caffaeb6c97a9&r=all |
| By: | Marsha Gold |
| Abstract: | This article examines the lessons and limits of Medicare Advantage, private health plans, and market competition as proposed solutions to traditional Medicare's rising costs and growing eligibility rolls. |
| Keywords: | Medicare Advantage , Health Care Costs , Eligibility Rolls , Insurance Coverage |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6d9eb5dacc6a4df4acd96877004b621e&r=all |
| By: | Ellen Englert Bouchery; Henrick J. Harwood; Joan Dilonardo; Rita Vandivort-Warren |
| Abstract: | A study recently published concluded that populations with different types of public health insurance have rates of receiving treatment for a substance use disorder that range from two to four times greater than the privately insured. |
| Keywords: | Substance Abuse Treatment , Access to Care , Insurance Coverage , Health |
| JEL: | I J |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0c7bcc0404d14e8fba09715ca0d93e9d&r=all |
| By: | Douadia Bougherara (CEE-M - Centre d'Economie de l'Environnement - Montpellier - FRE2010 - INRA - Institut National de la Recherche Agronomique - UM - Université de Montpellier - CNRS - Centre National de la Recherche Scientifique - Montpellier SupAgro - Institut national d’études supérieures agronomiques de Montpellier); Laurent Piet (SMART - Structures et Marché Agricoles, Ressources et Territoires - INRA - Institut National de la Recherche Agronomique - AGROCAMPUS OUEST) |
| Abstract: | A growing number of studies in finance and economics seek to explain insurance choices using the assumptions advanced by behavioral economics. One recent example in agricultural economics is the use of cumulative prospect theory (CPT) to explain farmer choices regarding crop insurance coverage levels (Babcock, 2015). We build upon this framework by deriving willingness to pay (WTP) for insurance programs under alternative assumptions, thus extending the model to incorporate farmer decisions regarding whether or not to purchase insurance. Our contribution is twofold. First, we study the sensitivity of farmer WTP for crop insurance to the inclusion of CPT parameters. We find that loss aversion and probability distortion increase WTP for insurance while risk aversion decreases it. Probability distortion in losses plays a particularly important role. Second, we study the impact of yield distribution skewness on farmer WTP assuming CPT preferences. We find that WTP decreases when the distribution of yields moves from negatively- to positively-skewed and that the combined effect of probability weighting in losses and skewness has a large negative impact on farmer WTP for crop insurance. |
| Keywords: | skewness,Crop Insurance,Cumulative Prospect Theory,premium subsidy |
| Date: | 2018–12–07 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpceem:hal-01947417&r=all |
| By: | Rosemary Borck; Allison Hedley Dodd; Ashley Zlatinov; Shinu Verghese; Rosalie Malsberger; Cara Petroski |
| Abstract: | A new Medicaid Analytic eXtract (MAX) chartbook summarizes the Medicaid program and the MAX data system. |
| Keywords: | MAX Chartbook , Medicaid Analytic eXtract , 2008 Chartbook , Health |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:41fd0559a659449996a60eadaa171764&r=all |
| By: | Thomas Boyer-Kassem (MAPP - Métaphysique allemande et philosophie pratique - Université de Poitiers); Sébastien Duchêne (CEE-M - Centre d'Economie de l'Environnement - Montpellier - FRE2010 - INRA - Institut National de la Recherche Agronomique - UM - Université de Montpellier - CNRS - Centre National de la Recherche Scientifique - Montpellier SupAgro - Institut national d’études supérieures agronomiques de Montpellier) |
| Abstract: | In many countries, private health insurance companies are allowed to vary their premiums based on some information on individuals. This practice is intuitively justified by the idea that people should pay the premium corresponding to their own known risk. However, one may consider this as a form of discrimination or wrongful differential treatment. Our goal in this paper is to assess whether profiling is ethically permissible in health insurance. We go beyond the existing literature in considering a wide range of parameters, be they genetic, non-genetic, or even non-medical such as age or place of living. Analyzing several ethical concerns, and tackling the difficult question of responsibility, we argue that profiling is generally unjust in health insurance |
| Keywords: | responsibility,health profiling,health insurance,discrimination,ethics |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpceem:hal-01975451&r=all |
| By: | Hector Galindo Silva; Nibene Habib Somé; Guy Tchuente; Nibene Habib Somé; Guy Tchuente |
| Abstract: | This paper explores the use of fuzzy regression-discontinuity design in the context where multiple treatments are applied at the threshold. It derives the conditions for identification of the effects of one of the treatments. The identification result shows that, under the strong assumption that the change in the probability of treatment at the cut off is equal across treatments, a difference-in-discontinuities estimator identifies the treatment effect of interest. Point identification of the treatment effect using fuzzy difference-in-discontinuities is impossible if the changes in the treatment probabilities are not equal across treatments. Estimable bounds of the treatment effect and a modification of the fuzzy difference-in-discontinuities are proposed under milder assumptions. These results suggest some caution when applying before-and-after methods in presence of fuzzy discontinuities. Using data from the National Health Interview Survey (NHIS), we apply this new identification strategy to evaluate the causal effect of the Affordable Care Act (ACA) on older Americans’ health care access and utilization. Our results suggest that the implementation of the Affordable Care Act has (1) led to 5% increase in the hospitalization rate of elderly Americans, (2) increased by 3.6% the probability of delaying care for cost reasons, and (3) exacerbated cost-related barriers to follow-up and continuity of care–7% more elderly could not afford prescriptions, 7% more could not see a specialist and, 5.5% more could not afford a follow-up visit- as a result of the ACA. |
| Keywords: | Fuzzy Difference-in-Discontinuities, Identification, Regression-Discontinuity Design, Affordable Care Act |
| JEL: | C13 I12 I13 I18 |
| Date: | 2019–02–15 |
| URL: | http://d.repec.org/n?u=RePEc:col:000416:017211&r=all |
| By: | James D. Reschovsky; Arkadipta Ghosh; Kate A. Stewart; Deborah J. Chollet |
| Abstract: | Significant variation for two service categories—durable medical equipment and home health—was greater than expected given their contribution to total Medicare costs. |
| Keywords: | Medical Equipment , Home Health , Medicare , Services |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0ce7781fde3547efb213bdcc77d23500&r=all |
| By: | Stéphane Auray (CREST; ENSAI; Université du Littoral Côte d’Opale); David L. Fuller (Université du Wisconsin-Oshkosh) |
| Abstract: | In this paper we investigate the causes and consequences of "unclaimed" unemployment insurance (UI) benefits. A search model is developed where the costs to collecting UI benefits include both a traditional "fixed" administrative cost and an endogenous cost arising from worker and firm interactions. Experience rated taxes give firms an incentive to challenge a worker's UI claim, and these challenges are costly for the worker. Exploiting data on improper denials of UI benefits across states in the U.S. system, a two-way fixed e ects analysis shows a statistically significant negative relationship between the improper denials and the UI take-up rate, providing empirical support for our model. We calibrate the model to elasticities implied by the two-way fixed e ects regression to quantify the relative size of these UI collection costs. The results imply that on average the costs associated with firm challenges of UI claims account for 42% of the total costs of collecting, with improper denials accounting for 6% of the total cost. The endogenous collection costs imply the unemployment rate responds much slower to changes in UI benefits relative to a model with fixed collection costs. Finally, removing all eligibility requirements and allowing workers to collect UI benefits without cost increases welfare by almost 5% with minimal impact on the unemployment rate. |
| Keywords: | Unemployment Insurance, Take-up Rate, Experience Rating, Matching Frictions, Search |
| JEL: | E61 J32 J64 J65 |
| Date: | 2018–10–03 |
| URL: | http://d.repec.org/n?u=RePEc:crs:wpaper:2018-18&r=all |
| By: | Congressional Budget Office |
| Abstract: | In recent years, the prices charged for specialty drugs have become a source of concern for many policymakers. Such drugs typically treat chronic, complex, or rare conditions, frequently have high prices, and may require special handling or patient monitoring. They accounted for a growing share of total net drug spending from 2010 to 2015 in both Medicare’s prescription drug benefit (Part D) and Medicaid. The net prices paid for specialty drugs are much higher in Medicare Part D than in Medicaid, and net spending on such drugs grew much faster in Medicare Part D than in Medicaid. |
| JEL: | I10 I11 I13 I18 |
| Date: | 2019–03–18 |
| URL: | http://d.repec.org/n?u=RePEc:cbo:report:54964&r=all |
| By: | Claudio Campanale (University of Turin and CeRP); Marcello Sartarelli (Universidad de Alicante) |
| Abstract: | Households appear to smooth consumption in the face of income shocks much more than implied by life-cycle versions of the standard incomplete market model under reference calibrations. In the current paper we explore in detail the role played by the life-cycle profile of wealth accumulation. We show that a standard model parameterized to match the latter can rationalize between 83 and more than 97 percent of the consumption insurance against permanent earnings shocks empirically estimated by Blundell, Pistaferri and Preston (2008), depending on the tightness of the borrowing limit. |
| Date: | 2018–11 |
| URL: | http://d.repec.org/n?u=RePEc:crp:wpaper:186&r=all |
| By: | Alex A. Bohl; Elizabeth A. Phelan; Paul. A. Fishman; Jeffrey R. Harris |
| Abstract: | This article examines the cost components that drive increased total costs after a medical fall over time, by severity of injury. |
| Keywords: | Economics , Medicaid , Medicare , Longitudinal Analysis |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:681c288322704f3cae54e7ad71716e5b&r=all |
| By: | Anna Anderson-Cook; Jared Maeda; Lyle Nelson |
| Abstract: | In this working paper, the Congressional Budget Office examines the prices paid for specialty drugs and spending on those drugs in Medicare Part D and Medicaid from 2010 to 2015. Specialty drugs treat chronic, complex, or rare conditions, frequently have high prices, and may require special handling or monitoring of patients. The retail prices paid to pharmacies for brand-name specialty drugs are similar in Medicare Part D and Medicaid, but net prices are much higher in Medicare Part D because rebates from manufacturers are substantially lower than in Medicaid. In 2015, the |
| JEL: | I10 I11 I13 I18 |
| Date: | 2019–03–18 |
| URL: | http://d.repec.org/n?u=RePEc:cbo:wpaper:55011&r=all |
| By: | Bruno Decreuse (AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - Ecole Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique); Guillaume Wilemme (AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - Ecole Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique) |
| Abstract: | A recent strand of papers use sharp regression discontinuity designs (RDD) based on age discontinuity to study the impacts of minimum income and unemployment insurance benefit extension policies. This design challenges job search theory, which predicts that such RDD estimates are biased. Owing to market frictions, people below the age threshold account for future eligibility to the policy. This progressively affects their search outcomes as they get closer to entitlement. Comparing them to eligible people leads to biased estimates because both groups of workers are actually treated. We provide a nonstationary job search model and quantify the theoretical biases on the datasets used in the literature. Our results suggest that the employment impact of minimum income policies are (significantly) under-estimated, whereas the impacts of benefit extensions on nonemployment duration are (not significantly) over-estimated. |
| Keywords: | RDD,age discontinuity,nonstationary job search theory |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-02072800&r=all |
| By: | Jeffrey R. Kling; Sendhil Mullainathan; Eldar Shafir; Lee C. Vermeulen; Marian V. Wrobel |
| Abstract: | We examine the extent of comparison friction in the market for Medicare Part D prescription drug plans in the United States. |
| Keywords: | Medicare Drug Plans , Medicare Part D , Health |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b5b408501b0147b89b7d124e831011e5&r=all |
| By: | Jeffrey T. Kullgren; Catherine G. McLaughlin; Nandita Mitra; Katrina Armstrong |
| Abstract: | Identifies prevalences and predictors of nonfinancial barriers that lead to unmet need or delayed care among U.S. adults. |
| Keywords: | Nonfinancial Barriers, Access to Care, Adult health care, health |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:50e8fbfb80d242358f36937e37b1de78&r=all |
| By: | Lisa I. Iezzoni; Sowmya R. Rao; Catherine M. DesRoches; Christine Vogeli; Eric G. Campbell |
| Abstract: | This article presents data from a 2009 survey of 1,891 practicing physicians nationwide. The survey assessed how widely physicians endorse and follow the Charter on Medical Professionalism's principles on openness and honesty in physicians' communication with patients. |
| Keywords: | High Quality Health Care System , Health Reform , Physician Survey , Patients |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b26c4caac265481088382daa69f04e04&r=all |
| By: | Pérez Blanco, Carlos Dionisio |
| Abstract: | Water is a key input in the production of many goods and services and under certain conditions can become a critical limiting factor with significant impacts on regional development. This is the case of many agricultural European Mediterranean basins, where water deficit during drought events is partially covered by illegal abstractions, mostly from aquifers, which are tolerated by the authorities. Groundwater overexploitation for irrigation has created in these areas an unprecedented environmental catastrophe that threatens ecosystems sustainability, urban water supply and the current model of development. Market-based drought insurance systems have the potential to introduce the necessary incentives to reduce overexploitation during drought events and remove the high costs of the drought indemnity paid by the government. This paper develops a methodology to obtain the optimum risk premium based on concatenated stochastic models. The methodology is applied to the agricultural district of Campo de Cartagena (Segura River Basin, Spain). Results show that the prices in a hypothetic competitive private drought insurance market would be reasonable and the expected environmental outcomes significant |
| Keywords: | Agricultural and Food Policy, Risk and Uncertainty |
| URL: | http://d.repec.org/n?u=RePEc:ags:feemcl:178242&r=all |
| By: | Shan Ge; Michael S. Weisbach |
| Abstract: | Many institutional investors depend on the returns they generate to fund their operations and liabilities. How does these investors’ demand for capital affect the management of their portfolios? We address this issue using the insurance industry because insurers are large investors for which detailed portfolio data are available, and can face financial shocks from exogenous weather-related events. We find that insurers with more financial flexibility have larger portfolio weights on riskier and more illiquid assets, and have higher realized returns. Among corporate bonds, for which we can control for regulatory treatment, we find that more financially flexible insurers have larger portfolio weights on riskier and more illiquid corporate bonds. Following losses, P&C insurers decrease allocations to riskier corporate bonds. The effect of losses on allocations is likely to be causal since it holds when instrumenting for P&C losses with weather shocks. The change in allocations following losses is larger for more financially constrained insurers and during the financial crisis, suggesting that the shift toward less risky securities is driven by concerns about financial flexibility. The results highlight the importance of financial flexibility to fund operations in institutional investors’ portfolio decisions. |
| JEL: | G11 G21 G22 G31 G32 |
| Date: | 2019–03 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:25677&r=all |
| By: | Zhao, Peiru |
| Abstract: | Agricultural insurance has been implemented for more than ten years in China. It is of great significance to analyse the impact of agricultural insurance on agricultural production in order to further design and promote innovative agricultural insurance. From a national perspective, 31 provinces in China are divided into four agricultural insurance development regions according to the level of economic development and agricultural development by cluster analysis. Then panel data model is used to analyse the impact of national and four regions agricultural insurance on agricultural production value. The empirical results show that the gross value of agricultural production is positively and significantly affected by agricultural insurance, planting area, loss ratio, and human capital. |
| Keywords: | Risk and Uncertainty |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:ags:aare19:285046&r=all |
| By: | Eugene C. Rich; Debra Lipson; Jenna Libersky; Deborah N. Peikes; Michael L. Parchman |
| Abstract: | This article summarizes strategies to help smaller primary care practices transform into medical homes that effectively serve patients with complex needs, particularly the frail elderly and working-age adults with disabilities. |
| Keywords: | Patient-Centered Medical Home , Organizing Care , Complex Patients , Health |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7f1916a6a3684930b58c73cf20614b61&r=all |
| By: | Deborah Peikes; Aparajita Zutshi; Janice L. Genevro; Michael L. Parchman; David S. Meyers |
| Abstract: | A new systematic review of evidence examines the effectiveness of the patient-centered medical home (PCMH) model on quality of care, affordability, and patient and professional experience. |
| Keywords: | Patient-Centered Medical Home , PCMH , Medical Home , Primary Care |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1094fccd7adf49af9c5894be24bd1dfc&r=all |