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Self-Insurance With Genetic Testing Tools

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  • David Crainich

Abstract

The development of genetic testing creates opportunities to better target disease prevention actions. In this article, we determine how the genetic information modifies self-insurance efforts in different health insurance market equilibria with adverse selection. We show that a regulation prohibiting insurers from using genetic information for rate-making purposes: (1) cancels the benefits of genetic testing when pooling equilibria occur and (2) does not prevent the exploitation of the benefits derived from genetic testing when separating equilibria (both of the Rothschild-Stiglitz or of the Miyazaki-Spence type) prevail in insurance markets.
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Suggested Citation

  • David Crainich, 2017. "Self-Insurance With Genetic Testing Tools," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 84(1), pages 73-94, March.
    • Handle: RePEc:bla:jrinsu:v:84:y:2017:i:1:p:73-94
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    File URL: http://hdl.handle.net/10.1111/jori.12085
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    1. Bardey, David & De Donder, Philippe, 2013. "Genetic testing with primary prevention and moral hazard," Journal of Health Economics, Elsevier, vol. 32(5), pages 768-779.
    2. Francesca Barigozzi & Dominique Henriet, 2011. "Genetic Information: Comparing Alternative Regulatory Approaches When Prevention Matters," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 13(1), pages 23-46, February.
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    7. Strohmenger, R. & Wambach, A., 2000. "Adverse selection and categorical discrimination in the health insurance markets: the effects of genetic tests," Journal of Health Economics, Elsevier, vol. 19(2), pages 197-218, March.
    8. Michael Rothschild & Joseph Stiglitz, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 90(4), pages 629-649.
    9. Hoel, Michael & Iversen, Tor, 2002. "Genetic testing when there is a mix of compulsory and voluntary health insurance," Journal of Health Economics, Elsevier, vol. 21(2), pages 253-270, March.
    10. Doherty, Neil A. & Thistle, Paul D., 1996. "Adverse selection with endogenous information in insurance markets," Journal of Public Economics, Elsevier, vol. 63(1), pages 83-102, December.
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    13. Michael Hoy & Fabienne Orsi & François Eisinger & Jean Paul Moatti, 2003. "The Impact of Genetic Testing on Healthcare Insurance," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 28(2), pages 203-221, April.
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    Cited by:

    1. Bardey, David & De Donder, Philippe, 2013. "Genetic testing with primary prevention and moral hazard," Journal of Health Economics, Elsevier, vol. 32(5), pages 768-779.
    2. 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.
    3. Martin Eling & Irina Gemmo & Danjela Guxha & Hato Schmeiser, 2024. "Big data, risk classification, and privacy in insurance markets," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 49(1), pages 75-126, March.
    4. Maik Dehnert, 2020. "Sustaining the current or pursuing the new: incumbent digital transformation strategies in the financial service industry," Business Research, Springer;German Academic Association for Business Research, vol. 13(3), pages 1071-1113, November.
    5. David Bardey & Philippe De Donder & Cesar Mantilla, 2014. "Adverse Selection vs Discrimination Risk with Genetic Testing. An Experimental Approach," CESifo Working Paper Series 5080, CESifo.
    6. 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).
    7. 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).
    8. 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.
    9. François Pannequin & Anne Corcos, 2023. "Risk Management and Public Policies: How prevention challenges monopolistic insurance markets," Documents de recherche 23-02, Centre d'Études des Politiques Économiques (EPEE), Université d'Evry Val d'Essonne.
    10. 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.
    11. 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.
    12. Christine Arentz, 2012. "Auswirkungen von Gentests in der Krankenversicherung," Otto-Wolff-Institut Discussion Paper Series 04/2012, Otto-Wolff-Institut für Wirtschaftsordnung, Köln, Deutschland.

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