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Endogenous information, adverse selection, and prevention: Implications for genetic testing policy

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  • Peter, Richard
  • Richter, Andreas
  • Thistle, Paul

Abstract

We examine public policy toward the use of genetic information by insurers. Individuals engage in unobservable primary prevention and have access to different prevention technologies. Thus, insurance markets are affected by moral hazard and adverse selection. Individuals can choose to take a genetic test to acquire information about their prevention technology. Information has positive decision-making value, that is, individuals may adjust their behavior based on the result of the test. However, testing also exposes individuals to uncertainty over the available insurance contract, so-called classification risk, which lowers the value of information. In our analysis we distinguish between four different policy regimes, determine the value of information under each regime and associated equilibrium outcomes on the insurance market. We show that the policy regimes can be Pareto ranked, with a duty to disclose being the preferred regime and an information ban the least preferred one.

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  • Peter, Richard & Richter, Andreas & Thistle, Paul, 2017. "Endogenous information, adverse selection, and prevention: Implications for genetic testing policy," Journal of Health Economics, Elsevier, vol. 55(C), pages 95-107.
  • Handle: RePEc:eee:jhecon:v:55:y:2017:i:c:p:95-107
    DOI: 10.1016/j.jhealeco.2017.06.010
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    Cited by:

    1. Bardey, David & De Donder, Philippe, 2019. "A Welfare Analysis of Genetic Testing in Health Insurance Markets with Adverse Selection and Prevention," TSE Working Papers 19-1035, Toulouse School of Economics (TSE), revised 22 Jan 2024.
    2. M. Martin Boyer & Franca Glenzer, 2021. "Pensions, annuities, and long-term care insurance: on the impact of risk screening," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 46(2), pages 133-174, September.
    3. Jisang Yu & Nathan P. Hendricks, 2020. "Input Use Decisions with Greater Information on Crop Conditions: Implications for Insurance Moral Hazard and the Environment," American Journal of Agricultural Economics, John Wiley & Sons, vol. 102(3), pages 826-845, May.
    4. Posey, Lisa L. & Thistle, Paul D., 2021. "Genetic testing and genetic discrimination: Public policy when insurance becomes “too expensive”," Journal of Health Economics, Elsevier, vol. 77(C).
    5. Bardey, David & De Donder, Philippe & Mantilla, César, 2019. "How is the trade-off between adverse selection and discrimination risk affected by genetic testing? Theory and experiment," Journal of Health Economics, Elsevier, vol. 68(C).
    6. Karlsson Linnér, Richard & Koellinger, Philipp D., 2022. "Genetic risk scores in life insurance underwriting," Journal of Health Economics, Elsevier, vol. 81(C).
    7. Diego C. Nocetti, 2018. "Ambiguity and the value of information revisited," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 43(1), pages 25-38, May.
    8. Tan, Kar Man & Gründl, Helmut, 2023. "Testing frequency and severity risk under various information regimes and implications in insurance," ICIR Working Paper Series 49/23, Goethe University Frankfurt, International Center for Insurance Regulation (ICIR).
    9. Louis Eeckhoudt & Anna Maria Fiori & Emanuela Rosazza Gianin, 2018. "Risk Aversion, Loss Aversion, and the Demand for Insurance," Risks, MDPI, vol. 6(2), pages 1-19, May.
    10. Simeon Schudy & Verena Utikal, 2018. "Does Imperfect Data Privacy Stop People from Collecting Personal Data?," Games, MDPI, vol. 9(1), pages 1-23, March.
    11. Mimra, Wanda & Nemitz, Janina & Waibel, Christian, 2020. "Voluntary pooling of genetic risk: A health insurance experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 180(C), pages 864-882.
    12. David Bardey & Philippe De Donder, 2015. "Welfare Impacts of Genetic Testing in Health Insurance Markets: Will Cross-Subsidies Survive?," Documentos CEDE 17220, Universidad de los Andes, Facultad de Economía, CEDE.
    13. M. Martin Boyer & Richard Peter, 2020. "Insurance Fraud in a Rothschild–Stiglitz World," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 87(1), pages 117-142, March.
    14. Kym Pram, 2023. "Learning And Evidence In Insurance Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 64(4), pages 1685-1714, November.
    15. Wanda Mimra & Janina Nemitz & Christian Waibel, 2019. "Voluntary pooling of genetic risk: A health insurance experiment," Post-Print hal-02499086, HAL.
    16. Stefan Felder, 2022. "Decision thresholds with genetic testing," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1071-1078, August.
    17. David Bardey & Philippe de Donder, 2023. "Personalized Medicine and Prevention: Can Cross-Subsidies Survive in the Health Insurance Markets ?," Working Papers hal-04082748, HAL.

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    More about this item

    Keywords

    Adverse selection; Information value; Insurance; Moral hazard; Prevention;
    All these keywords.

    JEL classification:

    • D11 - Microeconomics - - Household Behavior - - - Consumer Economics: Theory
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • G28 - Financial Economics - - Financial Institutions and Services - - - Government Policy and Regulation
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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