nep-ias New Economics Papers
on Insurance Economics
Issue of 2022‒02‒14
six papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Market forces in healthcare insurance: The impact of healthcare reform on regulated competition revisited By J.A.|info:eu-repo/dai/nl/06912261X Bikker; J.G.J. Bekooij
  2. Effect of health insurance in India: a randomized controlled trial By Anup Malani; Phoebe Holtzman; Kosuke Imai; Cynthia Kinnan; Morgen Miller; Shailender Swaminathan; Alessandra Voena; Bartosz Woda; Gabriella Conti
  3. Factors Associated with Disparities in Hospital Readmission Rates Among US Adults Dually Eligible for Medicare and Medicaid By David Silvestri; Demetri Goutos; Anouk Lloren; Sheng Zhou; Guohai Zhou; Thalia Farietta; Sana Charania; Jeph Herrin; Alon Peltz; Zhenqiu Lin; Susannah Bernheim
  4. How does education influence individuals' use of bequests as a long-term care insurance? By Edouard Ribes
  5. The Welfare Effects of Encouraging Rural-Urban Migration By David Lagakos; Mushfiq Mobarak; Michael E. Waugh
  6. Do Indian financial firms have a robust Grievance Redress Framework in place? By Balasubramaniam, Vimal; Sane, Renuka; Sarah, Mithila; Karthik Suresh

  1. By: J.A.|info:eu-repo/dai/nl/06912261X Bikker; J.G.J. Bekooij
    Abstract: This paper investigates the impact of market forces on competitive behaviour and efficiency in healthcare by investigating the Dutch healthcare insurance reform in 2006. This reform replaced the dual system of public and private insurance with a single compulsory health insurance scheme, in which insurance providers compete for customers in a free market. We measure competition directly from either shifts in market shares, or developments in profits. Using formal tests we find that in each approach a structural break occurs after the reform: competition is significantly higher after 2006 than before. Several robustness tests confirm this outcome. Nevertheless, we find that the health insurance sector is still less competitive than the banking, manufacturing and service industries, and even less competitive than life insurance.
    Keywords: (regulated) competition, concentration, healthcare insurance, performance-conduct-structure model, boone-indicator, scale economies
    Date: 2021–01
  2. By: Anup Malani (Institute for Fiscal Studies); Phoebe Holtzman (Institute for Fiscal Studies); Kosuke Imai (Institute for Fiscal Studies); Cynthia Kinnan (Institute for Fiscal Studies); Morgen Miller (Institute for Fiscal Studies); Shailender Swaminathan (Institute for Fiscal Studies); Alessandra Voena (Institute for Fiscal Studies and University of Chicago); Bartosz Woda (Institute for Fiscal Studies); Gabriella Conti (Institute for Fiscal Studies and University College London)
    Abstract: We report on a large randomized controlled trial of hospital insurance for above-poverty-line Indian households. Households were assigned to free insurance, sale of insurance, sale plus cash transfer, or control. To estimate spillovers, the fraction of households offered insurance varied across villages. The opportunity to purchase insurance led to 59.91% uptake and access to free insurance to 78.71% uptake. Access increased insurance utilization. Positive spillover effects on utilization suggest learning from peers. Many beneficiaries were unable to use insurance, demonstrating hurdles to expanding access via insurance. Across a range of health measures, we estimate no significant impacts on health.
    Date: 2021–12–07
  3. By: David Silvestri; Demetri Goutos; Anouk Lloren; Sheng Zhou; Guohai Zhou; Thalia Farietta; Sana Charania; Jeph Herrin; Alon Peltz; Zhenqiu Lin; Susannah Bernheim
    Abstract: Low-income older adults who are dually eligible (DE) for Medicare and Medicaid often experience worse outcomes following hospitalization.
    Keywords: dual eligibles, Medicare, Medicaid, hospital readmission rates, adults
  4. By: Edouard Ribes (CERNA i3 - Centre d'économie industrielle i3 - MINES ParisTech - École nationale supérieure des mines de Paris - PSL - Université Paris sciences et lettres - CNRS - Centre National de la Recherche Scientifique)
    Abstract: This paper proposes a simple economic model describing retirees' use of bequests. The model assumes that retirees need long term care and have preferences regarding the source of this support. Support can either be bought from the market (at a fixed rate) or sourced from within their family and compensated through bequests. When calibrated, the model shows that for individuals to get at least 1h of daily care, they must, independently of their education level, save about 20% of their pension in the early years of their retirement. However, differences in the source of support appear between non educated and educated households. It is indeed much easier to get support from family members in non-educated households compared to educated ones. Those results suggest that non educated households are also less likely to contract financial insurance products for long term care as they can easily leverage informal arrangements (i.e. their family).
    Keywords: Bequests,Inheritances,Intergenerational transfers,Wealth inequalities,Wealth management
    Date: 2021–12–21
  5. By: David Lagakos; Mushfiq Mobarak; Michael E. Waugh
    Abstract: This paper studies the welfare effects of encouraging rural-urban migration in the developing world. To do so, we build and analyze a dynamic general-equilibrium model of migration that features a rich set of migration motives. We estimate the model to replicate the results of a field experiment that subsidized seasonal migration in rural Bangladesh, leading to significant increases in migration and consumption. We show that the welfare gains from migration subsidies come from providing better insurance for vulnerable rural households rather than correcting spatial misallocation by relaxing credit constraints for those with high productivity in urban areas that are stuck in rural areas.
    Keywords: Risk; Insurance; Rural-urban gaps; Field experiment; Rural-urban migration; Spatial misallocation
    JEL: J61 R23 O11 O15
    Date: 2022–01–04
  6. By: Balasubramaniam, Vimal (Queen Mary University of London); Sane, Renuka (National Institute of Public Finance and Policy); Sarah, Mithila (National Institute of Public Finance and Policy); Karthik Suresh (National Institute of Public Finance and Policy)
    Abstract: A rapid expansion in the Indian financial sector has necessitated a growing focus on improving customer service which also includes the delivery of a robust Grievance Redressal Mechanism (GRM). A GRM is a formal system through which complaints are resolved in a time-bound manner, thus improving public service delivery in the financial system. This paper assesses the GRM policy content that is available on the website of 21 financial service providers in India. The firms include the top three firms by market share in each sector - banking, insurance, pensions, payments, mutual funds, and brokerages. Financial firms differ in their performance across different metrics, highlighting areas for improvement with grievance redress processes with financial services providers (FSP).
    Date: 2022–01

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