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The design of long term care insurance contracts

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  • Cremer, Helmuth
  • Lozachmeur, Jean-Marie
  • Pestieau, Pierre

Abstract

This paper studies the design of long term care (LTC) insurance contracts in the presence of ex post moral hazard. While this problem bears some similarity with the study of health insurance (Blomqvist, 1997) the significance of informal LTC affects the problem in several crucial ways. It introduces the potential crowding out of informal care by market care financed through insurance coverage. Furthermore, the information structure becomes more intricate. Informal care is not publicly observable and, unlike the insurer, caregivers know the true needs of their relatives. We determine the optimal second-best contract and show that the optimal reimbursement rate can be written as an A-B-C expression à la Diamond (1998). These terms respectively reflect the efficiency loss as measured by the inverse of the demand elasticity, the distribution of needs and the preferences for risk sharing. Interestingly, informal care directly affects only the first term. More precisely the first term decreases with the presence and significance of informal care. Roughly speaking this means that an efficient LTC insurance contract should offer lower (marginal) reimbursement rates than its counterpart in a health insurance context.

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  • Cremer, Helmuth & Lozachmeur, Jean-Marie & Pestieau, Pierre, 2016. "The design of long term care insurance contracts," Journal of Health Economics, Elsevier, vol. 50(C), pages 330-339.
    • Handle: RePEc:eee:jhecon:v:50:y:2016:i:c:p:330-339
    DOI: 10.1016/j.jhealeco.2016.08.008
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    Cited by:

    1. Justina Klimaviciute & Pierre Pestieau, 2018. "Long-term care social insurance: How to avoid big losses?," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 25(1), pages 99-139, February.
    2. Borsenberger, Claire & Cremer, Helmuth & Joram, Denis & Lozachmeur, Jean-Marie & Malavoltl, Estelle, 2024. "The design of insurance contracts for home versus nursing home Long-Term Care," CEPR Discussion Papers 19080, C.E.P.R. Discussion Papers.
    3. Marie‐Louise Leroux & Gregory Ponthiere, 2020. "Nursing home choice, family bargaining, and optimal policy in a Hotelling economy," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(4), pages 899-932, August.
    4. Justina Klimaviciute & Pierre Pestieau, 2023. "The economics of long‐term care. An overview," Journal of Economic Surveys, Wiley Blackwell, vol. 37(4), pages 1192-1213, September.
    5. Justina Klimaviciute & Pierre Pestieau, 2020. "Insurance with a deductible: a way out of the long term care insurance puzzle," Journal of Economics, Springer, vol. 130(3), pages 297-307, August.
    6. repec:bla:annpce:v:89:y:2018:i:1:p:49-63 is not listed on IDEAS
    7. Martin Eling & Omid Ghavibazoo, 2019. "Research on long-term care insurance: status quo and directions for future research," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 303-356, April.

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    More about this item

    Keywords

    Long term care; Private insurance; Public insurance; Informal care; Ex-post moral hazard; Crowding-out;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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