nep-ias New Economics Papers
on Insurance Economics
Issue of 2020‒12‒14
nineteen papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Specialty drugs: a distinctly American phenomenon By Naci, Huseyin; Kesselheim, Aaron S.
  2. On the benefits of index insurance in US agriculture: a large-scale analysis using satellite data By Matthieu Stigler; David Lobell
  3. Implementation and Impacts of the Substantial Gainful Activity Project Demonstration in Minnesota By Matthew Kehn; Todd Honeycutt
  4. The effect of unemployment insurance benefits on (self-)employment: Two sides of the same coin? By Camarero Garcia, Sebastian; Hansch, Michelle
  5. Who’s At Risk of Entering Social Security Disability Insurance? A Comparison of Application and Allowance Rates for Groups of At-Risk Individuals By Kara Contreary; Todd Honeycutt
  6. What can We Learn from State Disability Insurance Programs? By Yonatan Ben-Shalom
  7. Can International Competition Drive Insurance Market Growth? Evidence from Vietnam By World Bank
  8. Agriculture Risk Financing in Southern Africa By Felix Lung; Cristina Stefan
  9. The short-run impact of COVID-19 on the activity in the insurance industry in the Republic of North Macedonia By Viktor Stojkoski; Petar Jolakoski; Igor Ivanovski
  10. Brazil Rural Finance Policy Note By World Bank
  11. Sudden Stops, Productivity and the Optimal Level of International Reserves for Small Open Economies By Alexander Mihailov; Harun Nasir
  12. Improving Agriculture and Food Security Risk Financing in Southern Africa By World Bank
  13. Delivery System Reform Incentive Payments: Summative Evaluation Report By Julia Baller; Natalya Verbitsky-Savitz; Heather Dahlen; Christina Ribar; Natasha Reese-McLaughlin; Aaron Swaney
  14. Labor Supply Responses to Learning the Tax and Benefit Schedule By Kostol, Andreas Ravndal; Myhre, Andreas S.
  15. Home-based postnatal coordinated care after hospital discharge: a PRADO French experiment By Saad Zbiri; Patrick Rozenberg; Carine Milcent
  16. Federal Unemployment Reinsurance and Local Labor-Market Policies By Ignaszak, Marek; Jung, Philip; Kuester, Keith
  17. Unemployment insurance for the self-employed: a way forward post-corona By Schoukens, Paul; Weber, Enzo
  18. Maintaining Flexible Telehealth Policies After COVID-19 By Suzanne Felt-Lisk
  19. Unmet health care need and income-related horizontal equity in access during the COVID-19 pandemic By Davillas, Apostolos; Jones, Andrew M.

  1. By: Naci, Huseyin; Kesselheim, Aaron S.
    Abstract: Various stakeholders in the pharmaceutical supply chain assign the specialty label to drugs on the basis of a combination of several unrelated factors, including whether a drug treats a rare condition. But the single most common feature of specialty drugs is high cost.
    Keywords: Cost Sharing/economics; Cost-Benefit Analysis; Drug Costs/legislation & jurisprudence; Drug Industry/legislation & jurisprudence; Government Regulation; Humans; Insurance Coverage/economics; Insurance; Pharmaceutical Services/economics; Medicaid/economics; Medicare Part D/economics; Patient Protection and Affordable Care Act; Pharmaceutical Preparations/economics; Rare Diseases/drug therapy; United States
    JEL: J1
    Date: 2020–06–04
  2. By: Matthieu Stigler; David Lobell
    Abstract: Index insurance has been promoted as a promising solution for reducing agricultural risk compared to traditional farm-based insurance. By linking payouts to a regional factor instead of individual loss, index insurance reduces monitoring costs, and alleviates the problems of moral hazard and adverse selection. Despite its theoretical appeal, demand for index insurance has remained low in many developing countries, triggering a debate on the causes of the low uptake. Surprisingly, there has been little discussion in this debate about the experience in the United States. The US is an unique case as both farm-based and index-based products have been available for more than two decades. Furthermore, the number of insurance zones is very large, allowing interesting comparisons over space. As in developing countries, the adoption of index insurance is rather low -- less than than 5\% of insured acreage. Does this mean that we should give up on index insurance? In this paper, we investigate the low take-up of index insurance in the US leveraging a field-level dataset for corn and soybean obtained from satellite predictions. While previous studies were based either on county aggregates or on relatively small farm-level dataset, our satellite-derived data gives us a very large number of fields (close to 1.8 million) comprised within a large number of index zones (600) observed over 20 years. To evaluate the suitability of index insurance, we run a large-scale simulation comparing the benefits of both insurance schemes using a new measure of farm-equivalent risk coverage of index insurance. We make two main contributions. First, we show that in our simulations, demand for index insurance is unexpectedly high, at about 30\% to 40\% of total demand. This result is robust to relaxing several assumptions of the model and to using prospect theory instead of expected utility.
    Date: 2020–11
  3. By: Matthew Kehn; Todd Honeycutt
    Abstract: The Minnesota state vocational rehabilitation (VR) agency participated in a randomized control trial of an intervention designed to increase the earnings of Social Security Disability Insurance beneficiaries. This article present findings on the implementation experiences and the impacts the innovations had on service and employment outcomes.
    Keywords: Social Security Disability Insurance, Vocational Rehabilitation, Substantial Gainful Activity, employment, disability
  4. By: Camarero Garcia, Sebastian; Hansch, Michelle
    Abstract: Although a relevant share of firms is created out of unemployment and current active labor market policies in Europe often subsidize unemployed individuals to start their own businesses, little is known about the role of unemployment insurance (UI) generosity for self-employment. By using Spanish administrative data including so far inaccessible information on self-employment, we exploit a reform-driven exogenous cut in UI benefits to identify its causal effect on general employment and decompose it into the effects on self-employment and re-employment. Exploiting a discontinuity in the UI benefit schedule which changed as a result of the 2012 Spanish labor market reform, we estimate the causal reform effects on the extensive margin of (self-)employment and on unemployment duration. We find heterogeneous effects on the extensive margin: while the job-finding rate increases, the startup rate decreases. Over different time horizons, the negative effect on self- employment (35-50%) outweighs the positive effect on employment (5-33%). Therefore, omitting self-employment as a counterfactual outcome might lead to overestimate general employment effects. Our UI benefit duration elasticity estimates indicate that reduced UI benefits extend unemployment duration for individuals transitioning into self-employment but shorten unemployment for individuals finding re-employment. These results might be relevant for the (optimal) design of UI systems.
    Keywords: Social Insurance,Self-Employment,Spain,Unemployment Insurance
    JEL: H75 J64 J65 J68 L26
    Date: 2020
  5. By: Kara Contreary; Todd Honeycutt
    Abstract: Using three panels of the Survey of Income and Program Participation matched to SSA administrative data, we describe the employment characteristics of seven groups at risk of applying for DI benefits before and after application, as well as the outcomes of their DI applications.
    Keywords: Social Security Disability Insurance, individuals with disabilities, program application
  6. By: Yonatan Ben-Shalom
    Abstract: This book chapter examines the lessons from state temporary disability insurance (TDI) programs in helping workers return to work following an injury or illness.
    Keywords: disability, medical leave, workers, social insurance
  7. By: World Bank
    Keywords: Finance and Financial Sector Development - Finance and Development Finance and Financial Sector Development - Insurance & Risk Mitigation International Economics and Trade - Access to Markets
    Date: 2020–06
  8. By: Felix Lung; Cristina Stefan
    Keywords: Agriculture - Agricultural Sector Economics Agriculture - Climate Change and Agriculture Agriculture - Commodity Risk Management Environment - Natural Disasters Finance and Financial Sector Development - Insurance & Risk Mitigation Science and Technology Development - Climate and Meteorology
    Date: 2020–06
  9. By: Viktor Stojkoski; Petar Jolakoski; Igor Ivanovski
    Abstract: This paper investigates the impact of the COVID-19 pandemic on the insurance industry in the Republic of North Macedonia during the first half of 2020. By utilizing seasonal autoregressive models and data for 11 insurance classes, we find that the insurance activity shrank by more than 10% compared to what was expected. The total loss in the industry was, however, much less than the amount of funds made available by the Insurance Supervision Agency. This was because the pandemic induced changes in the activity structure - the share of Motor vehicles class fell at the expense of the property classes.
    Date: 2020–11
  10. By: World Bank
    Keywords: Agriculture - Agribusiness Agriculture - Agricultural Sector Economics Agriculture - Commodity Risk Management Finance and Financial Sector Development - Insurance & Risk Mitigation Rural Development - Agribusiness & Markets Rural Development - Rural Microfinance and SMEs
    Date: 2020–07
  11. By: Alexander Mihailov (Department of Economics, University of Reading); Harun Nasir (Department of Economics, Zonguldak Bülent Ecevit University)
    Abstract: This paper contributes to the theory of optimal international reserves by extending the Jeanne and Rancière (2011) endowments mall open economy (SOE) model to a SOE with capital and production that explicitly accounts for the main sources of economic growth. A first version of our set-up considers capital as the sole factor of production in the spirit of the AK model of endogenous growth with constant population, implying increasing returns to scale and justified on the grounds of its ability to generate sustained long-run growth, as observed empirically. Under a plausible calibration for typical emerging market countries facing the risk of sudden stops in capital inflows, we find that the optimal ratio of international reserves to output is 1.7%, which is quite lower than that in Jeanne and Rancière (2011), of 9.1%, even if calibrated to the same sample of 34 middle-income countries. A richer version then introduces also labour as a second factor in a conventional labour- augmenting Cobb-Douglas production function with constant returns to scale and exogenous population growth, consistent with a long-run balanced growth path and the sustained per capita income growth in the data. Under this alternative technology and the same calibration, we similarly find that the optimal reserves-to-output ratio for emerging market SOEs decreases - but not as much, being 5.5% - relative to the endowment case. We conclude that our results are explained by the role of capital accumulation as precautionary saving: the accumulated capital stock can potentially be used as a pledge to external creditors in obtaining borrowing, therefore insuring better a SOE against sudden stops.
    Keywords: optimal international reserves, small open economies, sudden stops,production technology, capital accumulation, precautionary saving, insurance contracts
    JEL: E21 E23 F32 F34 F41 O40
    Date: 2020–12–03
  12. By: World Bank
    Keywords: Agriculture - Agricultural Knowledge & Information Systems Agriculture - Commodity Risk Management Agriculture - Food Security Finance and Financial Sector Development - Insurance & Risk Mitigation
    Date: 2020–06
  13. By: Julia Baller; Natalya Verbitsky-Savitz; Heather Dahlen; Christina Ribar; Natasha Reese-McLaughlin; Aaron Swaney
    Abstract: This report summarizes findings from a five-year, mixed-methods evaluation of section 1115 Delivery System Reform Incentive Payment (DSRIP) demonstrations in four states.
    Keywords: Medicaid, value-based payment, ambulatory care, behavioral health, primary care
  14. By: Kostol, Andreas Ravndal (Arizona State University); Myhre, Andreas S. (Statistics Norway)
    Abstract: While optimization frictions have been shown to attenuate earnings responses to financial incentives, less is understood about the individual factors shaping the response. The main contribution of this paper is to separately quantify the role of learning the tax and benefit schedule versus other kinds of frictions. A unique combination of notches in the tax and benefit schedule and an information policy in a Norwegian welfare reform facilitate our study. The presence of notches allows us to measure overall frictions. Quasi-random assignment of a letter targeting misperceptions about the slope and locations of benefit phase-out regions allows us to pin down the role of information. Our analysis delivers two main findings. First, about 50% do not behave as predicted by standard labor supply models, and optimization frictions are particularly prevalent when financial incentives change. Without adjusting for these overall frictions, estimated elasticities would be attenuated by at least 70%. Second, the observed elasticity among those who receive the information letter is at least twice as large as among the non-informed, suggesting governments can partly offset the attenuation with information policy. Our calculations suggest misperceptions of the tax and benefit schedule account for two-thirds of the attenuation in earnings responses to financial work incentives. The findings have important implications for the effectiveness of tax and transfer policy.
    Keywords: labor supply, information, optimization frictions, social security, disability insurance
    JEL: H20 H31 H55 J22 J26
    Date: 2020–11
  15. By: Saad Zbiri (UVSQ - Université de Versailles Saint-Quentin-en-Yvelines); Patrick Rozenberg (Hôpital Poissy-saint Germain); Carine Milcent (PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)
    Abstract: Objective: To determine the factors that affect enrollment and full participation (adherence) in the PRADO home-based postnatal coordinated care program in France after hospital discharge. Methods: A population-based retrospective study was performed using the public health insurance database for the Yvelines district in France. The study population included all affiliated women admitted for delivery and classified as low risk in 2013. These women were eligible for home-based midwifery support after their discharge from the hospital. The enrollment and full participation of the women in home-based postnatal coordinated care were modeled using a simple probit model. Full participation in the home-based postnatal coordinated care was also modeled using a probit Heckman selection model in order to assess the self-selection process of enrollment in the program. The control variables were the characteristics of the patients, the municipalities, and the hospitals. Results: 2,859 (68.3%) of the 4,189 eligible women chose to participate in the home-based postnatal coordinated care program, of whom 2,496 (59.6% of the eligible women) subsequently took part in the entire PRADO program. On the one hand, enrollment in the home-based postnatal coordinated care was influenced mostly by family context variables including the woman's age at the time of her pregnancy and the number of children in the household, the woman's level of information including prenatal education and prenatal information regarding postpartum care, as well as hospital variables including characteristics and organization of the maternity units. On the other hand, full participation in the home-based postnatal coordinated care was influenced by the accessibility to health professionals, particularly midwives. 3 Furthermore, both the woman's level of information and accessibility to health professionals correlated with the socioeconomic environment. Conclusion: Women who become pregnant at a very early or late stage of their life as well as women with low levels of prenatal education and prenatal information regarding postpartum care have a relatively low rate of participation in home-based postnatal coordinated care. A public health policy promoting awareness of prenatal as well as postnatal issues could increase the participation in this coordinated community care. In addition, reducing regional inequality is likely to have a positive impact, as the availability of midwives is a key factor for participation in home-based postnatal coordinated care.
    Keywords: Postnatal care,Home-based coordinated care,Information,Health professional accessibility,Inequity
    Date: 2020–11
  16. By: Ignaszak, Marek (Goethe University Frankfurt); Jung, Philip (TU Dortmund); Kuester, Keith (University of Bonn)
    Abstract: Consider a union of atomistic member states, each faced with idiosyncratic business-cycle shocks. Private cross-border risk-sharing is limited, giving a role to a federal unemployment-based transfer scheme. Member states control local labor-market policies, giving rise to a trade-off between moral hazard and insurance. Calibrating the economy to a stylized European Monetary Union, we find notable welfare gains if the federal scheme's payouts take the member states' past unemployment level as a reference point. Member states' control over policies other than unemployment benefits can limit generosity during the transition phase.
    Keywords: unemployment reinsurance, labor-market policy, fiscal federalism, search and matching
    JEL: E32 E24 E62
    Date: 2020–11
  17. By: Schoukens, Paul; Weber, Enzo (Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany])
    Abstract: "With the COVID-19 crisis as background, the underlying paper elaborates on setting up an unemployment insurance for self-employed. While a comprehensive approach would have clear advantages, it is crucial to adapt the rules of existing insurances for wage earners appropriately addressing the specific needs of self-employed. Therefore, we discuss key rules and conditions with regard to self-employed and derive conclusions on how unemployment insurance for them should be designed. In this, we investigate the key elements of such an insurance. When it comes to financing the unemployment scheme, we discuss how an income related contribution levied on the running income of the self-employed person could be organised. With regard to entitlement, we argue for a detailed conditioning and monitoring of the closing down of the business rather than focusing upon the involuntary character. Before the background of surging short-time work in the COVID-19 crisis, we reason that a short-time work parallel for self-employed is possible to organise in order to handle exceptional events but would have to be designed with sufficient restrictions. In order to avoid false incentives for excessive repeated use of unemployment benefits, we propose a certain experience rating that is less abrupt than existing re-eligibility criteria and thus still provides continuous protection. Regarding labour market availability, we recommend to balance swift labour market integration and productive matching of entrepreneurial persons into self-employment by criteria giving leeway to self-employed activities as far as possible, but over time also guaranteeing an effective labour market integration. For dealing with the combination of multiple jobs and activities, we provide some guiding principles how to organise an unemployment insurance including entitlement and contributions in an integrated manner around activities, based on total work-related income." (Author's abstract, IAB-Doku) ((en))
    JEL: J65 J21
    Date: 2020–10–21
  18. By: Suzanne Felt-Lisk
    Abstract: To help federal policymakers organize their thinking around telehealth issues, this brief summarizes our review of the websites of 24 organizations representing providers, payers, patient advocates, and national-level health information technology organizations.
    Keywords: telehealth, Medicare, providers, payments
  19. By: Davillas, Apostolos; Jones, Andrew M.
    Abstract: Using monthly data from the Understanding Society (UKHLS) COVID-19 Survey we analyse the evolution of unmet need and assess how the UK health care system performed against the norm of horizontal equity in health care access during the first wave of COVID-19 wave. Unmet need was most evident for hospital care, and less pronounced for primary health services (medical helplines, GP consultations, local pharmacist advice, over the counter medications and prescriptions). Despite this, there is no evidence that horizontal equity, with respect to income, was violated for NHS hospital outpatient and inpatient care during the first wave of the pandemic. There is evidence of pro-rich inequities in access to GP consultations, prescriptions and medical helplines at the peak of the first wave, but these were eliminated as the pandemic progressed. There are persistent pro-rich inequities for services that relate to individuals' ability to pay (over the counter medications and advice from the local pharmacist).
    Keywords: inequity,COVID-19,unmet need,health care,UKHLS
    JEL: C1 D63 I14
    Date: 2020

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