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首页> 外文期刊>Journal of health economics >Risk selection and heterogeneous preferences in health insurance markets with a public option
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Risk selection and heterogeneous preferences in health insurance markets with a public option

机译：具有公共选择权的健康保险市场中的风险选择和异类偏好

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Conventional wisdom suggests that if private health insurance plans compete alongside a public option, they may endanger the latter's financial stability by cream-skimming good risks. This paper argues that two factors may contribute to the extent of cream-skimming: (i) degree of horizontal differentiation between public and private options when preferences are heterogeneous; (H) whether contract design encourages choice of private insurance before information about risk is revealed. I explore the role of these factors empirically within the unique institutional setting of the German health insurance system. Using a fuzzy regression discontinuity design to disentangle adverse selection and moral hazard, I find no compelling support for extensive cream-skimming of public option by private insurers despite their ability to fully underwrite risk. A model of demand for private insurance supports the idea that heterogeneity in non pecuniary preferences and long-term structure of private insurance contracts may be muting cream skimming in this setting. (C) 2016 Elsevier B.V. All rights reserved.
机译：传统观点认为，如果私人健康保险计划与公共选择权竞争，它们可能会因掠过良好风险而危及后者的财务稳定性。本文认为，有两个因素可能导致脱脂行为的严重程度：（i）当偏好异质时，公共和私人选择之间的水平区分程度； （H）合同设计是否鼓励在披露有关风险的信息之前选择私人保险。我凭经验探索了这些因素在德国健康保险体系独特机构设置中的作用。我使用模糊回归间断设计来消除不利选择和道德风险，尽管私人保险公司有能力完全承保风险，但我认为没有强有力的支持来支持私人保险公司对公共期权进行大量的脱脂处理。对私人保险的需求模型支持这样一种观点，即在这种情况下，非金钱偏好的异质性和私人保险合同的长期结构可能会使奶油撇清。 （C）2016 Elsevier B.V.保留所有权利。

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