IDEAS home Printed from https://ideas.repec.org/a/gam/jmathe/v11y2023i10p2240-d1143934.html
   My bibliography  Save this article

Optimal Private Health Insurance Contract towards the Joint Interests of a Policyholder and an Insurer

Author

Listed:
  • Peng Yang

    (School of Mathematics, Xi’an University of Finance and Economics, Xi’an 710100, China
    These authors contributed equally to this work.)

  • Zhiping Chen

    (School of Mathematics and Statistics, Xi’an Jiaotong University, Xi’an 710049, China
    Center for Optimization Technique and Quantitative Finance, Xi’an International Academy for Mathematics and Mathematical Technology, Xi’an 710049, China
    These authors contributed equally to this work.)

Abstract

This paper investigates the optimal private health insurance contract design problem, considering the joint interests of a policyholder and an insurer. Both the policyholder and the insurer jointly determine the premium of private health insurance. In order to better reflect reality, the illness expenditure is modelled by an extended compound Poisson process depending on health status. Under the mean–variance criterion and by applying dynamic programming, control theory, and leader–follower game techniques, analytically time-consistent private health insurance strategies are derived, optimal private health insurance contracts are designed, and their implications toward insurance are analysed. Finally, we perform numerical experiments assuming that the policyholder and the insurer calculate their wealth every year and they deposit their disposable income into the Bank of China with the interest rate being r = 0.021 . The values of other model parameters are set by referring to the data in the related literature. We find that the worse the policyholder’s health, the higher the premium that they pay for private health insurance, and buying private health insurance can effectively reduce the policyholder’s economic losses caused by illnesses.

Suggested Citation

  • 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.
  • Handle: RePEc:gam:jmathe:v:11:y:2023:i:10:p:2240-:d:1143934
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2227-7390/11/10/2240/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/2227-7390/11/10/2240/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Yao, Haixiang & Yang, Zhou & Chen, Ping, 2013. "Markowitz’s mean–variance defined contribution pension fund management under inflation: A continuous-time model," Insurance: Mathematics and Economics, Elsevier, vol. 53(3), pages 851-863.
    2. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    3. 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.
    4. Peng Yang & Zhiping Chen & Xiangyu Cui, 2021. "Equilibrium reinsurance strategies for n insurers under a unified competition and cooperation framework," Scandinavian Actuarial Journal, Taylor & Francis Journals, vol. 2021(10), pages 969-997, November.
    5. Kanika Kapur, 2020. "Private Health Insurance in Ireland: Trends and Determinants," The Economic and Social Review, Economic and Social Studies, vol. 51(1), pages 63-92.
    6. Pierre Martinon & Pierre Picard & Anasuya Raj, 2018. "On the design of optimal health insurance contracts under ex post moral hazard," The Geneva Papers on Risk and Insurance Theory, Springer;International Association for the Study of Insurance Economics (The Geneva Association), vol. 43(2), pages 137-185, September.
    7. Tomas Björk & Agatha Murgoci & Xun Yu Zhou, 2014. "Mean–Variance Portfolio Optimization With State-Dependent Risk Aversion," Mathematical Finance, Wiley Blackwell, vol. 24(1), pages 1-24, January.
    8. Peng Yang & Zhiping Chen & Liyuan Wang, 2021. "Time-consistent reinsurance and investment strategy combining quota-share and excess of loss for mean-variance insurers with jump-diffusion price process," Communications in Statistics - Theory and Methods, Taylor & Francis Journals, vol. 50(11), pages 2546-2568, June.
    9. Hambel, Christoph, 2020. "Health shock risk, critical illness insurance, and housing services," Insurance: Mathematics and Economics, Elsevier, vol. 91(C), pages 111-128.
    10. Baione, Fabio & Levantesi, Susanna, 2014. "A health insurance pricing model based on prevalence rates: Application to critical illness insurance," Insurance: Mathematics and Economics, Elsevier, vol. 58(C), pages 174-184.
    11. Migon, Helio S. & Moura, Fernando A.S., 2005. "Hierarchical Bayesian collective risk model: an application to health insurance," Insurance: Mathematics and Economics, Elsevier, vol. 36(2), pages 119-135, April.
    12. Muhammad Imam Ammarullah & Gatot Santoso & S. Sugiharto & Toto Supriyono & Dwi Basuki Wibowo & Ojo Kurdi & Mohammad Tauviqirrahman & J. Jamari, 2022. "Minimizing Risk of Failure from Ceramic-on-Ceramic Total Hip Prosthesis by Selecting Ceramic Materials Based on Tresca Stress," Sustainability, MDPI, vol. 14(20), pages 1-12, October.
    13. Blomqvist, Ake, 1997. "Optimal non-linear health insurance," Journal of Health Economics, Elsevier, vol. 16(3), pages 303-321, June.
    14. A. Y. Golubin, 2006. "Pareto‐Optimal Insurance Policies in the Models with a Premium Based on the Actuarial Value," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 73(3), pages 469-487, September.
    15. Ma, Ching-to Albert & McGuire, Thomas G, 1997. "Optimal Health Insurance and Provider Payment," American Economic Review, American Economic Association, vol. 87(4), pages 685-704, September.
    16. Chen, Zhiping & Yang, Peng, 2020. "Robust optimal reinsurance–investment strategy with price jumps and correlated claims," Insurance: Mathematics and Economics, Elsevier, vol. 92(C), pages 27-46.
    17. Menezes-Filho, Naercio & Politi, Ricardo, 2020. "Estimating the causal effects of private health insurance in Brazil: Evidence from a regression kink design," Social Science & Medicine, Elsevier, vol. 264(C).
    18. Brachetta, M. & Ceci, C., 2019. "Optimal proportional reinsurance and investment for stochastic factor models," Insurance: Mathematics and Economics, Elsevier, vol. 87(C), pages 15-33.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Liliana Chicaíza & Fredy Rodríguez & Mario García, 2006. "La equidad del mecanismo de pago por uso de servicios en el sistema de aseguramiento en salud de Colombia," Revista de Economía Institucional, Universidad Externado de Colombia - Facultad de Economía, vol. 8(15), pages 269-289, July-Dece.
    2. Liyuan Wang & Zhiping Chen, 2019. "Stochastic Game Theoretic Formulation for a Multi-Period DC Pension Plan with State-Dependent Risk Aversion," Mathematics, MDPI, vol. 7(1), pages 1-16, January.
    3. Boone, Jan, 2015. "Basic versus supplementary health insurance: Moral hazard and adverse selection," Journal of Public Economics, Elsevier, vol. 128(C), pages 50-58.
    4. Ellis, Randall P. & Manning, Willard G., 2007. "Optimal health insurance for prevention and treatment," Journal of Health Economics, Elsevier, vol. 26(6), pages 1128-1150, December.
    5. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    6. Ellis, Randall P. & Jiang, Shenyi & Manning, Willard G., 2015. "Optimal health insurance for multiple goods and time periods," Journal of Health Economics, Elsevier, vol. 41(C), pages 89-106.
    7. Galina Besstremyannaya & Sergei Golovan, 2019. "Physician’s altruism in incentive contracts: Medicare’s quality race," CINCH Working Paper Series 1903, Universitaet Duisburg-Essen, Competent in Competition and Health.
    8. Frank, Richard G. & Glazer, Jacob & McGuire, Thomas G., 2000. "Measuring adverse selection in managed health care," Journal of Health Economics, Elsevier, vol. 19(6), pages 829-854, November.
    9. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    10. Pierre Martinon & Pierre Picard & Anasuya Raj, 2017. "On the Design of Optimal Health Insurance Contracts under Ex Post Moral Hazard," Working Papers hal-01348551, HAL.
    11. Guan, Guohui & Hu, Xiang, 2022. "Equilibrium mean–variance reinsurance and investment strategies for a general insurance company under smooth ambiguity," The North American Journal of Economics and Finance, Elsevier, vol. 63(C).
    12. Guohui Guan, 2020. "Equilibrium and Precommitment Mean-Variance Portfolio Selection Problem with Partially Observed Price Index and Multiple Assets," Methodology and Computing in Applied Probability, Springer, vol. 22(1), pages 25-47, March.
    13. Jacques Drèze & Erik Schokkaert, 2013. "Arrow’s theorem of the deductible: Moral hazard and stop-loss in health insurance," Journal of Risk and Uncertainty, Springer, vol. 47(2), pages 147-163, October.
    14. Karen Eggleston & Richard Zeckhauser, 2002. "Government Contracting for Health Care," Discussion Papers Series, Department of Economics, Tufts University 0202, Department of Economics, Tufts University.
    15. Ed Westerhout & Kees Folmer, 2013. "Why it may hurt to be insured: the effects of capping coinsurance payments," CPB Discussion Paper 239, CPB Netherlands Bureau for Economic Policy Analysis.
    16. Sun, Jingyun & Li, Zhongfei & Zeng, Yan, 2016. "Precommitment and equilibrium investment strategies for defined contribution pension plans under a jump–diffusion model," Insurance: Mathematics and Economics, Elsevier, vol. 67(C), pages 158-172.
    17. Sidorenko, Alexandra, 2001. "Stochastic Model of Demand for Medical Care with Endogenous Labour Supply and Health Insurance," Departmental Working Papers 2001-08, The Australian National University, Arndt-Corden Department of Economics.
    18. Liran Einav & Amy Finkelstein & Heidi Williams, 2016. "Paying on the Margin for Medical Care: Evidence from Breast Cancer Treatments," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 52-79, February.
    19. Vaithianathan, Rhema, 2003. "Supply-side cost sharing when patients and doctors collude," Journal of Health Economics, Elsevier, vol. 22(5), pages 763-780, September.
    20. Udo Schneider, 2004. "Asymmetric Information and the Demand for Health Care – the Case of Double Moral Hazard," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 124(2), pages 233-256.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jmathe:v:11:y:2023:i:10:p:2240-:d:1143934. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.