IDEAS home Printed from https://ideas.repec.org/a/kap/ijhcfe/v19y2019i3d10.1007_s10754-018-9255-y.html
   My bibliography  Save this article

Genetic variation in health insurance coverage

Author

Listed:
  • George L. Wehby

    (University of Iowa
    University of Iowa
    University of Iowa
    University of Iowa)

  • Dan Shane

    (University of Iowa)

Abstract

We provide the first investigation into whether and how much genes explain having health insurance coverage or not and possible mechanisms for genetic variation. Using a twin-design that compares identical and non-identical twins from a national sample of US twins from the National Survey of Midlife Development in the United States, we find that genetic effects explain over 40% of the variation in whether a person has any health coverage versus not, and nearly 50% of the variation in whether individuals younger than 65 have private coverage versus whether they have no coverage at all. Nearly one third of the genetic variation in being uninsured versus having private coverage is explained by employment industry, self-employment status, and income, and together with education, they explain over 40% of the genetic influence. Marital status, number of children, and available measures of health status, risk preferences, and prevention effort do not appear to be important channels for genetic effects. That genes have meaningful effects on the insurance status suggests an important source of heterogeneity in insurance take up.

Suggested Citation

  • George L. Wehby & Dan Shane, 2019. "Genetic variation in health insurance coverage," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 301-316, December.
  • Handle: RePEc:kap:ijhcfe:v:19:y:2019:i:3:d:10.1007_s10754-018-9255-y
    DOI: 10.1007/s10754-018-9255-y
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10754-018-9255-y
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1007/s10754-018-9255-y?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. David M. Cutler & Richard J. Zeckhauser, 1998. "Adverse Selection in Health Insurance," NBER Chapters, in: Frontiers in Health Policy Research, Volume 1, pages 1-32, National Bureau of Economic Research, Inc.
    2. Camelia M Kuhnen & Joan Y Chiao, 2009. "Genetic Determinants of Financial Risk Taking," PLOS ONE, Public Library of Science, vol. 4(2), pages 1-4, February.
    3. S. Rabe-Hesketh & A. Skrondal & H. K. Gjessing, 2008. "Biometrical Modeling of Twin and Family Data Using Standard Mixed Model Software," Biometrics, The International Biometric Society, vol. 64(1), pages 280-288, March.
    4. David Cesarini & Magnus Johannesson & Paul Lichtenstein & Örjan Sandewall & Björn Wallace, 2010. "Genetic Variation in Financial Decision‐Making," Journal of Finance, American Finance Association, vol. 65(5), pages 1725-1754, October.
    5. David M. Cutler & Amy Finkelstein & Kathleen McGarry, 2008. "Preference Heterogeneity and Insurance Markets: Explaining a Puzzle of Insurance," American Economic Review, American Economic Association, vol. 98(2), pages 157-162, May.
    6. Oster, Emily & Shoulson, Ira & Quaid, Kimberly & Dorsey, E. Ray, 2010. "Genetic adverse selection: Evidence from long-term care insurance and Huntington disease," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 1041-1050, December.
    7. David Cesarini & Christopher T. Dawes & Magnus Johannesson & Paul Lichtenstein & Björn Wallace, 2009. "Genetic Variation in Preferences for Giving and Risk Taking," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 809-842.
    8. David M. Cutler & Adriana Lleras-Muney, 2006. "Education and Health: Evaluating Theories and Evidence," NBER Working Papers 12352, National Bureau of Economic Research, Inc.
    9. Charney, Evan & English, William, 2013. "Genopolitics and the Science of Genetics," American Political Science Review, Cambridge University Press, vol. 107(2), pages 382-395, May.
    10. George L. Wehby & Benjamin W. Domingue & Jason D. Boardman, 2015. "Prevention, Use of Health Services, and Genes: Implications of Genetics for Policy Formation," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 34(3), pages 519-536, June.
    11. Boardman, Jason D. & Domingue, Benjamin W. & Daw, Jonathan, 2015. "What can genes tell us about the relationship between education and health?," Social Science & Medicine, Elsevier, vol. 127(C), pages 171-180.
    12. Henrik Cronqvist & Stephan Siegel, 2015. "The Origins of Savings Behavior," Journal of Political Economy, University of Chicago Press, vol. 123(1), pages 123-169.
    13. Verhulst, Brad & Hatemi, Peter K., 2013. "Gene-Environment Interplay in Twin Models," Political Analysis, Cambridge University Press, vol. 21(3), pages 368-389, July.
    14. Hanming Fang & Michael P. Keane & Dan Silverman, 2008. "Sources of Advantageous Selection: Evidence from the Medigap Insurance Market," Journal of Political Economy, University of Chicago Press, vol. 116(2), pages 303-350, April.
    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. Steven F. Lehrer & Weili Ding, 2017. "Are genetic markers of interest for economic research?," IZA Journal of Labor Policy, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 6(1), pages 1-23, December.
    2. Camelia M Kuhnen & Gregory R Samanez-Larkin & Brian Knutson, 2013. "Serotonergic Genotypes, Neuroticism, and Financial Choices," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-9, January.
    3. Kiichi Tokuoka, 2017. "Is stock investment contagious among siblings?," Empirical Economics, Springer, vol. 52(4), pages 1505-1528, June.
    4. Sandra E Black & Paul J Devereux & Petter Lundborg & Kaveh Majlesi, 2020. "Poor Little Rich Kids? The Role of Nature versus Nurture in Wealth and Other Economic Outcomes and Behaviours," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 87(4), pages 1683-1725.
    5. Nicos Nicolaou & Scott Shane, 2019. "Common genetic effects on risk-taking preferences and choices," Journal of Risk and Uncertainty, Springer, vol. 59(3), pages 261-279, December.
    6. Dreber, Anna & Rand, David G. & Wernerfelt, Nils & Garcia, Justin R. & Lum, J. Koji & Zeckhauser, Richard, 2011. "The Dopamine Receptor D4 Gene (DRD4) and Self-Reported Risk Taking in the Economic Domain," Working Paper Series rwp11-042, Harvard University, John F. Kennedy School of Government.
    7. Nathaniel Hendren & Camille Landais & Johannes Spinnewijn, 2021. "Choice in Insurance Markets: A Pigouvian Approach to Social Insurance Design," Annual Review of Economics, Annual Reviews, vol. 13(1), pages 457-486, August.
    8. Henrik Cronqvist & Florian Münkel & Stephan Siegel, 2014. "Genetics, Homeownership, and Home Location Choice," The Journal of Real Estate Finance and Economics, Springer, vol. 48(1), pages 79-111, January.
    9. Andra C. Ghent & Marianna Kudlyak, 2015. "Intergenerational Linkages in Household Credit," Working Paper 15-14, Federal Reserve Bank of Richmond.
    10. Zimmermann, Klaus F. & Chowdhury, Shyamal & Sutter, Matthias, 2020. "Economic preferences across generations and family clusters: A large-scale experiment," CEPR Discussion Papers 14998, C.E.P.R. Discussion Papers.
    11. Raj Chetty & Amy Finkelstein, 2012. "Social Insurance: Connecting Theory to Data," NBER Working Papers 18433, National Bureau of Economic Research, Inc.
    12. Hübler, Philipp, 2017. "Heritability of time preference: Evidence from German twin data," MPRA Paper 77620, University Library of Munich, Germany.
    13. Xu, Yilan & Briley, Daniel A. & Brown, Jeffrey R. & Roberts, Brent W., 2017. "Genetic and environmental influences on household financial distress," Journal of Economic Behavior & Organization, Elsevier, vol. 142(C), pages 404-424.
    14. De Neve, Jan-Emmanuel & Fowler, James H., 2014. "Credit card borrowing and the monoamine oxidase A (MAOA) gene," Journal of Economic Behavior & Organization, Elsevier, vol. 107(PB), pages 428-439.
    15. David Cesarini & Magnus Johannesson & Patrik K. E. Magnusson & Björn Wallace, 2012. "The Behavioral Genetics of Behavioral Anomalies," Management Science, INFORMS, vol. 58(1), pages 21-34, January.
    16. Levy, Moshe, 2015. "An evolutionary explanation for risk aversion," Journal of Economic Psychology, Elsevier, vol. 46(C), pages 51-61.
    17. Philipp Huebler, 2017. "Heritability of time preference: Evidence from German twin data," Discussion Paper Series 334, Universitaet Augsburg, Institute for Economics.
    18. DeVault, Luke & Sias, Richard, 2017. "Hedge fund politics and portfolios," Journal of Banking & Finance, Elsevier, vol. 75(C), pages 80-97.
    19. Alma Cohen & Peter Siegelman, 2010. "Testing for Adverse Selection in Insurance Markets," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 39-84, March.
    20. Guiso, Luigi & Sodini, Paolo, 2013. "Household Finance: An Emerging Field," Handbook of the Economics of Finance, in: G.M. Constantinides & M. Harris & R. M. Stulz (ed.), Handbook of the Economics of Finance, volume 2, chapter 0, pages 1397-1532, Elsevier.

    More about this item

    Keywords

    Health insurance; Genetic variation; Health determinants; Risk taking;
    All these keywords.

    JEL classification:

    • D1 - Microeconomics - - Household Behavior
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    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:kap:ijhcfe:v:19:y:2019:i:3:d:10.1007_s10754-018-9255-y. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.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.