Dong Jing, Smieliauskas Fabrice, Konetzka R Tamara
IMPAQ International, Columbia, MD, USA.
The University of Chicago, Chicago, IL, USA.
Geneva Pap Risk Insur Issues Pract. 2019 Apr;44(2):277-302. doi: 10.1057/s41288-018-00113-7. Epub 2018 Dec 3.
Although private long-term care insurance (LTCI) is often discussed as a potential solution to the need for long-term care financing in the U.S., there is little empirical evidence on the economic consequences of having LTCI. We use U.S. Health and Retirement Study data to examine how LTCI affects key financial outcomes of insured individuals. Using an instrumental variable approach to account for the endogeneity of LTCI purchase, we find that LTCI leads to consistently positive effects on assets, consistently negative effects on Medicaid and Food Stamp enrolment and parent-child financial transfers, and ambiguous effects on out-of-pocket medical payments. These results suggest that although private LTCI does not entirely protect insured individuals against large medical expenditure, it improves the general financial well-being of insured individuals, potentially by reducing Medicaid-related disincentives to asset accumulation, motivating individuals to save more and reduce intergenerational wealth transfers.
尽管私人长期护理保险(LTCI)常被视为解决美国长期护理资金需求的潜在方案,但关于拥有LTCI的经济后果的实证证据却很少。我们利用美国健康与退休研究数据,研究LTCI如何影响被保险人的关键财务状况。采用工具变量法来处理LTCI购买的内生性问题,我们发现LTCI对资产产生持续的正向影响,对医疗补助和食品券登记以及亲子间财务转移产生持续的负向影响,而对自付医疗费用的影响则不明确。这些结果表明,虽然私人LTCI并不能完全保护被保险人免受大额医疗支出的影响,但它可能通过减少与医疗补助相关的资产积累抑制因素、促使个人更多储蓄以及减少代际财富转移,从而改善被保险人的总体财务状况。