nep-ias New Economics Papers
on Insurance Economics
Issue of 2021‒11‒22
eight papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. A Social Insurance Perspective on Pandemic Fiscal Policy: Implications for Unemployment Insurance and Hazard Pay By Christina D. Romer; David H. Romer
  2. The Effects of the Affordable Care Act on Agricultural Workers By Donkor, Kwabena B.; Perloff, Jeffrey M.; Gabbard, Susan
  3. Fraud detection in the era of Machine Learning: a household insurance case By Denisa BANULESCU-RADU; Meryem YANKOL-SCHALCK
  4. The Effect of ACA Medicaid Expansions on Foster Care Admissions By Louis-Philippe Beland; Jason Huh; Dongwoo Kim
  5. Adopting Index Insurance and/or Precautionary Savings: Peer Effects in Complex Decision-Making in Uzbek Experiments By Moritz, Laura; Kuhn, Lena; Bobojonov, Ihtiyor; Glauben, Thomas
  6. Too much trade: the hidden problem of adverse selection By De Meza, David; Reito, Francesco; Reyniers, Diane J.
  7. The Right to Health and the Health Effects of Denials By Bhalotra, Sonia; Fernandez, Manuel
  8. A Hard Look at “Soft” Cost‐control Measures in Healthcare Organizations: Evidence from Preferred Drug Policies in Germany By Avdic, Daniel; Blankart, Katharina

  1. By: Christina D. Romer; David H. Romer
    Abstract: This paper considers fiscal policy during the pandemic through the lens of optimal social insurance. We develop a simple framework to analyze how government taxes and transfers could mimic the insurance against pandemic income losses that people would like to have had. Permutations of the framework provide insight into how unemployment insurance should be structured, when and how much hazard pay is called for, and whether fiscal policy should aim just to redistribute income or also to stimulate aggregate demand during a pandemic. When we use the insights from the model to evaluate unemployment insurance measures taken during the pandemic, we find that some, but far from all, of the implications of the social insurance framework were followed. In the case of hazard pay, we find that the proposal for a national program (the never-implemented HEROES Act) was both broader and more generous than a social insurance perspective would call for. We suggest that the social insurance perspective on fiscal policy is likely to become increasingly relevant as pandemics and climate-related natural disasters become more common causes of unemployment and recessions.
    JEL: E62 E65 H21 H31 I18
    Date: 2021–10
  2. By: Donkor, Kwabena B. (Stanford Institute of Economic Policy Research); Perloff, Jeffrey M. (University of California, Berkeley); Gabbard, Susan (JBS International, INC)
    Abstract: The Affordable Care Act substantially increased the share of farmworkers with medical insurance, but it had little effect on employer-provided benefits, including health care insurance. Eligible workers with pre-existing health conditions consumed substantially more medical services, unlike those without these conditions. Contrary to expectations, the ACA did not have a significant effect on emergency room usage.
    JEL: I13 J32 J43
    Date: 2021–03
    Keywords: , Fraud detection, Household insurance, Machine learning, Logistic LASSO, XGBoost,, Imbalanced data, SHAP
    Date: 2021
  4. By: Louis-Philippe Beland (Department of Economics, Carleton University); Jason Huh (Department of Economics, Rensselaer Polytechnic Institute); Dongwoo Kim (Department of Economics, Texas Christian University)
    Abstract: Recent papers have documented positive externalities of Medicaid expansions on several nonhealth related variables, such as crime, financial stress, child support, and child abuse.
    Keywords: Affordable Care Act, Health Insurance, Foster Care, Child Abuse
    JEL: I13 I18 J13 K36
    Date: 2021–08–12
  5. By: Moritz, Laura; Kuhn, Lena; Bobojonov, Ihtiyor; Glauben, Thomas
    Keywords: Risk and Uncertainty
    Date: 2021–08
  6. By: De Meza, David; Reito, Francesco; Reyniers, Diane J.
    Abstract: Adverse selection famously leads to the crowding out of socially benecial trades. We show that even more trades may be simultaneously crowded in. The reason is that, in the absence of complete unravelling, \lemons" fetch more under adverse selection. It is demonstrated how these \bad" trades occur in insurance, credit and used-car markets, and some policy implications are discussed.
    Keywords: adverse selection; insurance; credit; used cars
    JEL: C13 D14 D82
    Date: 2021–10–29
  7. By: Bhalotra, Sonia (University of Warwick); Fernandez, Manuel (Universidad de los Andes)
    Abstract: We investigate supply-side barriers to medical care in Colombia, where citizens have a constitutional right to health, but insurance companies impose restrictions. We use administrative data on judicial claims for health as a proxy for unmet demand. We validate this using the health services utilization register, showing that judicial claims map into large, pervasive decreases in medical consultations, procedures, hospitalizations and emergency care. This manifests in population health outcomes. We identify increases in mortality pervasive across cause, age and sex, with larger increases for cancer, individuals over the age of fty, women and the poor.
    Date: 2021
  8. By: Avdic, Daniel; Blankart, Katharina
    Abstract: Cost‐control interventions that target physicians’ clinical discretion are common in healthcare, but evidence on their efficacy is scarce; in particular for “soft” policies when liability is unlikely to be enforced by the regulator. We study the effectiveness of preferred drug policies (minimum prescription quotas of specific “preferred” drugs) in altering physicians practice styles within the high volume drug class of HMG‐CoA‐reductase inhibitors (statins) in the German statutory health insurance system. Using a nationally representative panel of ambulatory care physicians between 2011 and 2014, we exploit the decentralized institutional setting to estimate physician responses to variation in preferred drug policies across regional physician associations over time in a generalized difference‐in‐differences design. Results show that although the cost‐control mechanism increases average policy adherence, this effect is mainly driven by physicians with initially high use rates of preferred drugs. We argue that such misdirection may limit the policy’s usefulness in reducing inappropriate practice variation among healthcare providers.
    Keywords: Cost-control, Healthcare, Practice Style, Difference-in-differences
    Date: 2021–11–10

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