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Testing for adverse selection into private medical insurance

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Author Info
Pau Olivella
Marcos Vera-Hernandez () (Institute for Fiscal Studies and University College London)

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Abstract

We develop a test for adverse selection and use it to examine private health insurance markets. In contrast to earlier papers that consider a purely private system or a system in which private insurance supplements a public system, we focus our attention on a system where privately funded health care is substitutive of the publicly funded one. Using a model of competition among insurers, we generate predictions about the correlation between risk and the probability of taking private insurance under both symmetric information and adverse selection. These predictions constitute the basis for our adverse selection test. The theoretical model is also useful to conclude that the setting that we focus on is especially attractive to test for adverse selection. Using the British Household Panel Survey, we find evidence that adverse selection is present in this market.

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Publisher Info
Paper provided by Institute for Fiscal Studies in its series IFS Working Papers with number W06/02.

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Length: 48 pp.
Date of creation: Jan 2006
Date of revision:
Handle: RePEc:ifs:ifsewp:06/02

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Related research
Keywords: Contract theory; Testing; Health Insurance;

Find related papers by JEL classification:
D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information
I19 - Health, Education, and Welfare - - Health - - - Other
G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies

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References listed on IDEAS
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  1. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456. [Downloadable!]
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    Other versions:
  3. Chiappori, Pierre Andre & Salanie, Bernard, 2002. "Testing Contract Theory: A Survey of Some Recent Work," CESifo Working Paper Series CESifo Working Paper No. , CESifo Group Munich. [Downloadable!]
    Other versions:
  4. Coulson, N.E. & Terza, J. & Neslusan, C.A. & Stuart, B., 1995. "Estimating the Moral Hazard Effect of Supplemental Medical Insurance in the Demand for Prescription Drugs by the Elderly," Papers 04-95-01, Pennsylvania State - Department of Economics.
    Other versions:
  5. Gouveia, Miguel, 1997. " Majority Rule and the Public Provision of a Private Good," Public Choice, Springer, vol. 93(3-4), pages 221-44, December. [Downloadable!] (restricted)
    Other versions:
  6. Chiappori, Pierre-Andre & Salanie, Bernard, 1997. "Empirical contract theory: The case of insurance data," European Economic Review, Elsevier, vol. 41(3-5), pages 943-950, April. [Downloadable!] (restricted)
  7. Lucien Gardiol & Pierre-Yves Geoffard & Chantal Grandchamp, 2003. "Separating Selection and Incentive Effects: an Econometric Study of Swiss Health Insurance Claims Data," DELTA Working Papers 2003-27, DELTA (Ecole normale supérieure). [Downloadable!]
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    Other versions:
  9. Besley, Timothy & Hall, John & Preston, Ian, 1998. "Private and public health insurance in the UK," European Economic Review, Elsevier, vol. 42(3-5), pages 491-497, May. [Downloadable!] (restricted)
  10. Propper, Carol, 1989. "An Econometric Analysis of the Demand for Private Health Insurance in England and Wales," Applied Economics, Taylor and Francis Journals, vol. 21(6), pages 777-92, June.
  11. Roger Feldman & Carlos Escribano & Laura Pellisé, 1998. "The role of government in health insurance markets with adverse selection," Health Economics, John Wiley & Sons, Ltd., vol. 7(8), pages 659-670.
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    Other versions:
  13. John Cawley & Tomas Philipson, 1999. "An Empirical Examination of Information Barriers to Trade in Insurance," American Economic Review, American Economic Association, vol. 89(4), pages 827-846, September. [Downloadable!] (restricted)
    Other versions:
  14. Propper, Carol, 1993. "Constrained choice sets in the U.K. demand for private medical insurance," Journal of Public Economics, Elsevier, vol. 51(3), pages 287-307, July. [Downloadable!] (restricted)
  15. Ángel Marcos Vera-Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598.
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    Other versions:
  20. Amy Finkelstein & James Poterba, 2004. "Adverse Selection in Insurance Markets: Policyholder Evidence from the U.K. Annuity Market," Journal of Political Economy, University of Chicago Press, vol. 112(1), pages 183-208, February. [Downloadable!] (restricted)
    Other versions:
  21. Carol Propper & Alan Maynard, 1989. "The market for private health care and the demand for private insurance in Britain," Working Papers 053chedp, Centre for Health Economics, University of York. [Downloadable!]
  22. repec:rus:hseeco:16303 is not listed on IDEAS
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  24. Alma Cohen & Liran Einav, 2005. "Estimating Risk Preferences from Deductible Choice," NBER Working Papers 11461, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  25. Cameron, A C & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Blackwell Publishing, vol. 55(1), pages 85-106, January. [Downloadable!] (restricted)
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    Other versions:
  28. Jaap H. Abbring & James J. Heckman & Pierre-André Chiappori & Jean Pinquet, 2003. "Adverse Selection and Moral Hazard In Insurance: Can Dynamic Data Help to Distinguish?," Journal of the European Economic Association, MIT Press, vol. 1(2-3), pages 512-521, 04/05. [Downloadable!] (restricted)
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