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道德风险与长期护理保险

Moral hazard and long-term care insurance.

作者信息

Konetzka R Tamara, He Daifeng, Dong Jing, Nyman John A

机构信息

Department of Public Health Sciences and Department of Medicine, The University of Chicago Biological Sciences, University of Chicago, 5841 S. Maryland Ave., Room W255, MC2000,Chicago, IL 60637, USA.

Swarthmore College, Swarthmore, PA, USA.

出版信息

Geneva Pap Risk Insur Issues Pract. 2019 Apr;44(2):231-251. doi: 10.1057/s41288-018-00119-1. Epub 2019 Jan 21.

Abstract

In private long-term care insurance markets, moral hazard is central to pricing and long-run robustness of the market, yet there is remarkably little evidence on the extent to which moral hazard is present in long-term care insurance. We use Health and Retirement Study data from 1996 to 2014 to assess moral hazard in nursing home and home care use in private long-term care insurance, employing a combination of propensity score matching and instrumental variables approaches. We find evidence of significant moral hazard in home care use and a potentially meaningful but noisy effect on nursing home use. Policymakers designing incentives to promote private long-term care insurance should consider the consequences of moral hazard.

摘要

在私人长期护理保险市场中,道德风险是定价和市场长期稳健性的核心问题,但关于长期护理保险中道德风险的存在程度,证据却极为稀少。我们利用1996年至2014年的健康与退休研究数据,采用倾向得分匹配和工具变量方法相结合的方式,评估私人长期护理保险中养老院和家庭护理使用方面的道德风险。我们发现了家庭护理使用中存在重大道德风险的证据,以及对养老院使用有潜在显著但有噪音影响的证据。设计激励措施以促进私人长期护理保险的政策制定者应考虑道德风险的后果。

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本文引用的文献

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Decomposition of moral hazard.道德风险分解。
J Health Econ. 2018 Jan;57:168-178. doi: 10.1016/j.jhealeco.2017.12.003. Epub 2017 Dec 11.
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Wealth, income, and the affordability of health insurance.财富、收入与医疗保险的可承受性。
Health Aff (Millwood). 2009 May-Jun;28(3):887-96. doi: 10.1377/hlthaff.28.3.887.
9
Moral hazard in nursing home use.养老院使用中的道德风险。
J Health Econ. 2007 May 1;26(3):560-77. doi: 10.1016/j.jhealeco.2006.10.003. Epub 2006 Nov 13.
10
Why don't people buy long-term-care insurance?为什么人们不购买长期护理保险?
J Gerontol B Psychol Sci Soc Sci. 2006 Jul;61(4):S185-93. doi: 10.1093/geronb/61.4.s185.

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