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Does Adverse Selection Matter? Evidence from a Natural Experiment

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  • Grönqvist, Erik

    () (Centre for Health Economics)

Abstract

The empirical evidence of adverse selection in insurance markets is mixed. The problem in assessing the extent of adverse selection is that private information, on which agents act, is generally unobservable to the researcher, which makes it difficult to distinguish between adverse selection and moral hazard. Unique micro data, from a dental insurance natural experiment, is here used to provide a direct test of selection. All agents in a population were stratified into different risk classes, and were unexpectedly given the opportunity to insure their dental care costs. The setup of the insurance makes it possible to observe a proxy for private information. Interestingly, results differ across risk classes. Within high-risk classes, there is evidence of adverse selection and within low-risk classes, the results, surprisingly, indicate an advantageous selection. This dual selection can explain the limited empirical evidence for adverse selection in insurance markets in the literature: the two effects may balance out on the aggregate level. The paper also presents a model of insurance choice that can harbor both adverse and advantageous selection. The pattern in the data is explained by differences in the effectiveness of prevention across high and low risk classes.

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Bibliographic Info

Paper provided by Stockholm School of Economics in its series Working Paper Series in Economics and Finance with number 575.

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Length: 38 pages
Date of creation: 10 Nov 2004
Date of revision:
Handle: RePEc:hhs:hastef:0575

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Related research

Keywords: Asymmetric information; Adverse Selection; Advantageous Selection; Health Insurance;

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References

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  1. Dionne, G. & Eeckhoudt, L., 1984. "Self-Insurance, Self-Protection and Increased Risk Aversion," Cahiers de recherche 8424, Universite de Montreal, Departement de sciences economiques.
  2. John Cawley & Tomas Philipson, 1997. "An Empirical Examination of Information Barriers to Trade inInsurance," University of Chicago - George G. Stigler Center for Study of Economy and State 132, Chicago - Center for Study of Economy and State.
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  8. Amy Finkelstein & James Poterba, 2002. "Selection Effects in the United Kingdom Individual Annuities Market," Economic Journal, Royal Economic Society, vol. 112(476), pages 28-50, January.
  9. Kaïs Dachraoui & Georges Dionne & Louis Eeckhoudt & Philippe Godfroid, 2004. "Comparative Mixed Risk Aversion: Definition and Application to Self-Protection and Willingness to Pay," Journal of Risk and Uncertainty, Springer, vol. 29(3), pages 261-276, December.
  10. Monica Paiella & Luigi Guiso, 2004. "Risk Aversion, Wealth and Background Risk," 2004 Meeting Papers 525, Society for Economic Dynamics.
  11. David M. Cutler & Sarah Reber, 1996. "Paying for Health Insurance: The Tradeoff between Competition and Adverse Selection," NBER Working Papers 5796, National Bureau of Economic Research, Inc.
  12. Dachraoui, K. & Dionne, G. & Eeckhoudt, L. & Godfroid, P., 2000. "Comparative Mixed Risk Aversion," Ecole des Hautes Etudes Commerciales de Montreal- 00-10, Ecole des Hautes Etudes Commerciales de Montreal-Chaire de gestion des risques..
  13. Olsson, Christina, 1999. "Essays in the Economics of Dental Insurance and Dental Health," UmeÃ¥ Economic Studies 494, Umeå University, Department of Economics.
  14. Akerlof, George A, 1970. "The Market for 'Lemons': Quality Uncertainty and the Market Mechanism," The Quarterly Journal of Economics, MIT Press, vol. 84(3), pages 488-500, August.
  15. Cameron, A. Colin & Trivedi, Pravin K., 1991. "The role of income and health risk in the choice of health insurance : Evidence from Australia," Journal of Public Economics, Elsevier, vol. 45(1), pages 1-28, June.
  16. Cardon, James H & Hendel, Igal, 2001. "Asymmetric Information in Health Insurance: Evidence from the National Medical Expenditure Survey," RAND Journal of Economics, The RAND Corporation, vol. 32(3), pages 408-27, Autumn.
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Cited by:
  1. Grönqvist, Erik, 2006. "(M)oral Hazard?," Working Paper Series in Economics and Finance 642, Stockholm School of Economics.

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