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Advantageous selection in private health insurance: The case of Australia

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Author Info
Thomas Buchmueller (University of Michigan)
Denzil Fiebig (University of NSW)
Glenn Jones (Macquarie University)
Elizabeth Savage () (CHERE, University of Technology, Sydney)

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Abstract

When consumers have private information about risk of suffering a loss, or equivalently, if insurers are prohibited from using observable information on risk in underwriting, theoretical models of insurance predict adverse selection. Yet the most common finding in empirical studies is that of no positive correlation between risk and insurance coverage. This is found for different types of insurance (e.g. car, health, life) and in different countries (e.g. France, US, UK, Israel) suggesting a fundamental relationship involving private information and consumer preferences. In this paper, we investigate the nature of risk selection in the Australian market for private health insurance in which community rated private health insurance complements a universal public health care system. We use National Health Survey data on hospital utilisation and individual characteristics to construct an empirical analogue for the risk variable in the Rothschild and Stiglitz model. Estimating the relationship between insurance and risk semi-parametrically, we find robust evidence of favourable selection. To explore the extent to which underlying risk preferences rather than risk drives the decision to purchase health insurance, we use Household Expenditure Survey data to model decisions to purchase a range of insurance products (health, life, accident, home, car) and to engage in risky behaviours (smoking and various forms of gambling). Correlations between residuals in the model suggest that advantageous selection is driven by risk aversion, which theoretical models do not typically capture.

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File URL: http://www.chere.uts.edu.au/pdf/wp2008_2.pdf
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File Function: First version, May 2008
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Publisher Info
Paper provided by CHERE, University of Technology, Sydney in its series Working Papers with number 2008/2.

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Date of creation: May 2008
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Handle: RePEc:her:chewps:2008/2

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Related research
Keywords: health insurance; adverse selection; Australia;

Find related papers by JEL classification:
I10 - Health, Education, and Welfare - - Health - - - General

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Pierre-Andre Chiappori & Bernard Salanie, 2001. "Testing for Asymmetric Information in Insurance Markets," Journal of Political Economy, University of Chicago Press, vol. 108(1), pages 56-78, February. [Downloadable!] (restricted)
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  2. Pierre-André Chiappori ; Bruno Jullien ; Bernard Salanié ; François Salanié, 2002. "Asymmetric Information in Insurance : General Testable Implications," Working Papers 2002-42, Centre de Recherche en Economie et Statistique. [Downloadable!]
  3. Cao, Zhun & McGuire, Thomas G., 2003. "Service-level selection by HMOs in Medicare," Journal of Health Economics, Elsevier, vol. 22(6), pages 915-931, November. [Downloadable!] (restricted)
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Cited by:
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  1. Bolhaar, Jonneke & Lindeboom, Maarten & van der Klaauw, Bas, 2008. "A Dynamic Analysis of the Demand for Health Insurance and Health Care," IZA Discussion Papers 3698, Institute for the Study of Labor (IZA). [Downloadable!]
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