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Selection bias and moral hazard in the Australian private health insurance market: Evidence from the Queensland skin cancer database

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  • Nghiem, Son
  • Graves, Nicholas

Abstract

This study estimates the effects of moral hazard and selection bias in private insurance by exploiting the unique characteristics of private health insurance in Australia using a longitudinal data of about 37,000 individuals. We estimate determinants of private health insurance status and health service consumption together as a system to control for individual unobserved effects. We also take into account the evolution of the health production process by controlling for the lagged dependent variables. We found that risk-averse individuals were more likely to purchase private health insurance, suggesting an advantageous selection. There is also evidence of ex-post moral hazard as privately insured individuals consumed more health services. Controlling for the lagged health service consumption reduces the magnitude of moral hazard considerably. The presence of advantageous selection and moral hazard in private health insurance indicates that the Australian healthcare system can be more efficient by increasing coverage and monitoring consumption.

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  • Nghiem, Son & Graves, Nicholas, 2019. "Selection bias and moral hazard in the Australian private health insurance market: Evidence from the Queensland skin cancer database," Economic Analysis and Policy, Elsevier, vol. 64(C), pages 259-265.
    • Handle: RePEc:eee:ecanpo:v:64:y:2019:i:c:p:259-265
    DOI: 10.1016/j.eap.2019.09.008
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    References listed on IDEAS

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    1. Rachel J. Huang & Arthur Snow & Larry Y. Tzeng, 2017. "Advantageous Selection in Insurance Markets with Compound Risk," The Geneva Papers on Risk and Insurance Theory, Springer;International Association for the Study of Insurance Economics (The Geneva Association), vol. 42(2), pages 171-192, September.
    2. Jaap H. Abbring & Pierre-André Chiappori & Jean Pinquet, 2003. "Moral Hazard and Dynamic Insurance Data," Journal of the European Economic Association, MIT Press, vol. 1(4), pages 767-820, June.
    3. Keane, Michael & Stavrunova, Olena, 2016. "Adverse selection, moral hazard and the demand for Medigap insurance," Journal of Econometrics, Elsevier, vol. 190(1), pages 62-78.
    4. Schmitz, Patrick W., 2002. "On the Interplay of Hidden Action and Hidden Information in Simple Bilateral Trading Problems," Journal of Economic Theory, Elsevier, vol. 103(2), pages 444-460, April.
    5. Jaap H. Abbring & Pierre-André Chiappori & Jean Pinquet, 2003. "Moral Hazard and Dynamic Insurance Data," Journal of the European Economic Association, MIT Press, vol. 1(4), pages 767-820, June.
    6. Buchmueller, Thomas C. & Fiebig, Denzil G. & Jones, Glenn & Savage, Elizabeth, 2013. "Preference heterogeneity and selection in private health insurance: The case of Australia," Journal of Health Economics, Elsevier, vol. 32(5), pages 757-767.
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    Cited by:

    1. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    2. Lan Nguyen & Andrew C. Worthington, 2023. "Moral hazard in Australian private health insurance: the case of dental care services and extras cover," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 157-176, January.
    3. Clifford Afoakwah & Joshua Byrnes & Paul Scuffham & Son Nghiem, 2023. "Testing for selection bias and moral hazard in private health insurance: Evidence from a mixed public‐private health system," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 3-24, January.
    4. Peng Yang & Zhiping Chen, 2023. "Optimal Private Health Insurance Contract towards the Joint Interests of a Policyholder and an Insurer," Mathematics, MDPI, vol. 11(10), pages 1-28, May.

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