IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this book or follow this series

Assurabilité et développement de l'assurance dépendance

  • Lorenzi, Jean-Hervé
  • Plisson, Manuel
Registered author(s):

    The private long-term care insurance (LTCI) market is a puzzle, in France and in several developed countries (United-States, Spain, etc. . . ). The long-term care insurance market is small, yet long-term care is one of the largest uninsured financial risks facing the elderly. In addition public insurance is small in most countries. This research develops a new analysis of this long-term care insurance puzzle. It examines, on the basis of a new data set for France, whether the limited size of the insurance market is explained by market failures, or whether this sub optimal result is linked to institutional reasons ? The research leads to four results. In the first part, I argue that it is possible to push back the insurability frontier for long-term care at home. In the second part, I illustrate how individual preferences may lead some persons not to seek insure, and this for at least two reasons : an incomplete insurance contract ; current and expected health condition has a strong e§ect on wealth utility. On the basis of my data set, I argue that long-term care insurance can become a mass product particularly appreciated by middle classes. In the last part, I show, using standard tests, that there is no adverse selection on the private long-term care insurance market. This could be explained by offsetting effects. In view of these four results, I argue that the current limited size of LTCI market can be better explained by institutional reasons (social insurance criteria, tax disincentives) rather than by market failure. There are no economic obstacles to the development of this market. Nevertheless, a small share of the population will prefer not to insure.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL: http://basepub.dauphine.fr/xmlui/bitstream/123456789/5064/1/these_Plisson_Dependance.pdf
    Download Restriction: no

    as
    in new window

    This book is provided by Paris Dauphine University in its series Economics Thesis from University Paris Dauphine with number 123456789/5064 and published in 2009.
    Order: http://basepub.dauphine.fr/xmlui/handle/123456789/5064
    Handle: RePEc:dau:thesis:123456789/5064
    Note: dissertation
    Contact details of provider: Web page: http://www.dauphine.fr/en/welcome.html

    More information through EDIRC

    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.:

    as in new window
    1. Tomas Philipson & John Cawley, 1999. "An Empirical Examination of Information Barriers to Trade in Insurance," American Economic Review, American Economic Association, vol. 89(4), pages 827-846, September.
    2. Becker, Gary S, 1974. "A Theory of Social Interactions," Journal of Political Economy, University of Chicago Press, vol. 82(6), pages 1063-93, Nov.-Dec..
    3. Zeckhauser, Richard, 1970. "Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives," Journal of Economic Theory, Elsevier, vol. 2(1), pages 10-26, March.
    4. M. Duée & C. Rebillard, 2004. "Old age disability in France: a long run projection," Documents de Travail de la DESE - Working Papers of the DESE g2004-02, Institut National de la Statistique et des Etudes Economiques, DESE.
    5. Kahneman, Daniel & Tversky, Amos, 1979. "Prospect Theory: An Analysis of Decision under Risk," Econometrica, Econometric Society, vol. 47(2), pages 263-91, March.
    6. repec:cai:recosp:reco_p1995_46n3_0933 is not listed on IDEAS
    7. PESTIEAU, Pierre & SATO, Motohiro, 2004. "Long term care: the state, the market and the family," CORE Discussion Papers 2004082, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    8. Plisson, Manuel, 2009. "Le marché de l'assurance dépendance," Economics Papers from University Paris Dauphine 123456789/5867, Paris Dauphine University.
    9. Hakansson, Nils H, 1969. "Optimal Investment and Consumption Strategies under Risk, an Uncertain Lifetime, and Insurance," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 10(3), pages 443-66, October.
    10. Sloan, Frank A & Norton, Edward C, 1997. "Adverse Selection, Bequests, Crowding Out, and Private Demand for Insurance: Evidence from the Long-Term Care Insurance Market," Journal of Risk and Uncertainty, Springer, vol. 15(3), pages 201-19, December.
    11. Costa-Font, Joan & Rovira-Forns, Joan, 2008. "Who is willing to pay for long-term care insurance in Catalonia?," Health Policy, Elsevier, vol. 86(1), pages 72-84, April.
    12. Miles S. Kimball, 1989. "Precautionary Saving in the Small and in the Large," NBER Working Papers 2848, National Bureau of Economic Research, Inc.
    13. Yaari, Menahem E, 1987. "The Dual Theory of Choice under Risk," Econometrica, Econometric Society, vol. 55(1), pages 95-115, January.
    14. David McCarthy & Olivia S. Mitchell, 2003. "International Adverse Selection in Life Insurance and Annuities," NBER Working Papers 9975, National Bureau of Economic Research, Inc.
    15. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    16. Michael D. Hurd & Kathleen McGarry, 2002. "The Predictive Validity of Subjective Probabilities of Survival," Economic Journal, Royal Economic Society, vol. 112(482), pages 966-985, October.
    17. 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.
    18. Laurence Assous & Ronan Mahieu, 2002. "L'assurabilité de la dépendance et sa prise en charge par le secteur privé. Une mise en perspective internationale," Revue économique, Presses de Sciences-Po, vol. 53(4), pages 887-912.
    19. 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.
    20. Stiglitz, Joseph E & Weiss, Andrew, 1981. "Credit Rationing in Markets with Imperfect Information," American Economic Review, American Economic Association, vol. 71(3), pages 393-410, June.
    21. Shleifer, Andrei & Summers, Lawrence H. & Bernheim, B. Douglas, 1986. "The Strategic Bequest Motive," Scholarly Articles 3721794, Harvard University Department of Economics.
    22. EECKHOUDT, Louis & SCHLESINGER, Harris, . "Putting risk in its proper place," CORE Discussion Papers RP -1871, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    23. R. Glenn Hubbard & Jonathan Skinner & Stephen P. Zeldes, 1994. "Precautionary Saving and Social Insurance," NBER Working Papers 4884, National Bureau of Economic Research, Inc.
    24. Laurence Assous & Ronan Mahieu, 2002. "L'assurabilité de la dépendance et sa prise en charge par le secteur privé. Une mise en perspective internationale," Revue Économique, Programme National Persée, vol. 53(4), pages 887-912.
    25. Christophe Courbage & Nolwenn Roudaut, 2008. "Empirical Evidence on Long-term Care Insurance Purchase in France*," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan, vol. 33(4), pages 645-658, October.
    26. Olivia S. Mitchell & James M. Poterba & Mark J. Warshawsky, 1997. "New Evidence on the Money's Worth of Individual Annuities," NBER Working Papers 6002, National Bureau of Economic Research, Inc.
    27. Igal Hendel & Alessandro Lizzeri, 2003. "The Role Of Commitment In Dynamic Contracts: Evidence From Life Insurance," The Quarterly Journal of Economics, MIT Press, vol. 118(1), pages 299-327, February.
    28. Mehra, Rajnish & Prescott, Edward C., 1985. "The equity premium: A puzzle," Journal of Monetary Economics, Elsevier, vol. 15(2), pages 145-161, March.
    29. Viscusi, W Kip & Evans, William N, 1990. "Utility Functions That Depend on Health Status: Estimates and Economic Implications," American Economic Review, American Economic Association, vol. 80(3), pages 353-74, June.
    30. Friedberg Leora & Webb Anthony, 2007. "Life Is Cheap: Using Mortality Bonds to Hedge Aggregate Mortality Risk," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 7(1), pages 1-33, July.
    31. repec:hal:journl:hal-00283170 is not listed on IDEAS
    32. David Alary & Franck Bien, 2008. "Assurance santé et sélection adverse. L'incidence des maladies invalidantes," Revue économique, Presses de Sciences-Po, vol. 59(4), pages 737-748.
    33. Louis Eeckhoudt & Neil Doherty, 1995. "Espérance d'utilité et théorie duale de Yaari : implication pour la demande d'assurance," Revue Économique, Programme National Persée, vol. 46(3), pages 933-938.
    34. JOUSTEN, Alain & LIPSZYC, Barbara & MARCHAND, Maurice & PESTIEAU, Pierre, 2003. "Long-term care in insurance and optimal taxation for altruistic children," CORE Discussion Papers 2003063, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    35. Jacky Bonotaux & Christophe Barret & François Magnien, 2003. "La mesure des prix dans les domaines de la santé et de l'action sociale : quelques problèmes méthodologiques," Économie et Statistique, Programme National Persée, vol. 361(1), pages 3-25.
    36. Smith, V. Kerry & Taylor, Donald H., Jr. & Sloan, Frank A., 2000. "Longevity Expectations and Death: Can People Predict Their Own Demise?," Working Papers 00-15, Duke University, Department of Economics.
    37. Daniel S. Hamermesh, 1982. "Expectations, Life Expectancy, and Economic Behavior," NBER Working Papers 0835, National Bureau of Economic Research, Inc.
    38. Darius Lakdawalla & Tomas Philipson, 2002. "The Rise in Old-Age Longevity and the Market for Long-Term Care," American Economic Review, American Economic Association, vol. 92(1), pages 295-306, March.
    39. Villeneuve, Bertrand, 2003. "Concurrence et antisélection multidimensionnelle en assurance," Economics Papers from University Paris Dauphine 123456789/5370, Paris Dauphine University.
    40. Darius Lakdawalla & Dana Goldman & Jay Bhattacharya, 2001. "Are the Young Becoming More Disabled?," NBER Working Papers 8247, National Bureau of Economic Research, Inc.
    41. Rothschild, Michael & Stiglitz, Joseph E, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, MIT Press, vol. 90(4), pages 630-49, November.
    42. Hoerger, Thomas J & Picone, Gabriel A & Sloan, Frank A, 1996. "Public Subsidies, Private Provision of Care and Living Arrangements of the Elderly," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 428-40, August.
    43. Brown, Jeffrey R. & Finkelstein, Amy, 2007. "Why is the market for long-term care insurance so small?," Journal of Public Economics, Elsevier, vol. 91(10), pages 1967-1991, November.
    44. Amy Finkelstein & James Poterba, 2004. "Adverse Selection in Insurance Markets: Policyholder Evidence from the U.K. Annuity Market," Journal of Political Economy, University of Chicago Press, vol. 112(1), pages 183-208, February.
    45. repec:hal:journl:hal-00325882 is not listed on IDEAS
    46. Fitzgerald, John M, 1989. "The Taste for Bequests and Well-Being of Widows: A Model of Life Insurance Demand by Married Couples," The Review of Economics and Statistics, MIT Press, vol. 71(2), pages 206-14, May.
    47. Bernheim, B Douglas, 1991. "How Strong Are Bequest Motives? Evidence Based on Estimates of the Demand for Life Insurance and Annuities," Journal of Political Economy, University of Chicago Press, vol. 99(5), pages 899-927, October.
    48. Arrow, Kenneth J & Lind, Robert C, 1970. "Uncertainty and the Evaluation of Public Investment Decisions," American Economic Review, American Economic Association, vol. 60(3), pages 364-78, June.
    49. Béatrice Rey, 2003. "A Note on Optimal Insurance in the presence of a Nonpecuniary Background Risk," Theory and Decision, Springer, vol. 54(1), pages 73-83, February.
    50. Bardey, David & Lesur, Romain, 2005. "Optimal health insurance contract: Is a deductible useful?," Economics Letters, Elsevier, vol. 87(3), pages 313-317, June.
    51. Eugene Fama & F. & Kenneth R. French, . "The Equity Premium."," CRSP working papers 522, Center for Research in Security Prices, Graduate School of Business, University of Chicago.
    52. Pascale Genier, 1996. "La gestion du risque dépendance : le rôle de la famille, de l'État et du secteur privé," Économie et Statistique, Programme National Persée, vol. 291(1), pages 103-117.
    53. Jeffrey R. Brown & Amy Finkelstein, 2008. "The Interaction of Public and Private Insurance: Medicaid and the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 98(3), pages 1083-1102, June.
    54. Gaetan Lafortune & Gaëlle Balestat, 2007. "Trends in Severe Disability Among Elderly People: Assessing the Evidence in 12 OECD Countries and the Future Implications," OECD Health Working Papers 26, OECD Publishing.
    55. Wilson, Charles, 1977. "A model of insurance markets with incomplete information," Journal of Economic Theory, Elsevier, vol. 16(2), pages 167-207, December.
    56. De Meza, D. & Webb, D.C., 2000. "Advantageous Selection in Insurance Market," Discussion Papers 0007, Exeter University, Department of Economics.
    57. Dahlby, Bev & West, Douglas S, 1986. "Price Dispersion in an Automobile Insurance Market," Journal of Political Economy, University of Chicago Press, vol. 94(2), pages 418-38, April.
    58. Amy Finkelstein & Kathleen McGarry, 2003. "Private Information and its Effect on Market Equilibrium: New Evidence from Long-Term Care Insurance," NBER Working Papers 9957, National Bureau of Economic Research, Inc.
    59. Pauly, Mark V & Kunreuther, Howard & Hirth, Richard, 1995. "Guaranteed Renewability in Insurance," Journal of Risk and Uncertainty, Springer, vol. 10(2), pages 143-56, March.
    60. Pauly, Mark V, 1990. "The Rational Nonpurchase of Long-term-Care Insurance," Journal of Political Economy, University of Chicago Press, vol. 98(1), pages 153-68, February.
    61. Legal, Renaud, 2008. "Les déterminants de la demande individuelle de couverture complémentaire santé en France," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/189 edited by Joël, Marie-Eve.
    62. Richard J. Arnott & Joseph E. Stiglitz, 1988. "The Basic Analytics of Moral Hazard," NBER Working Papers 2484, National Bureau of Economic Research, Inc.
    63. 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.
    64. Cook, Philip J & Graham, Daniel A, 1977. "The Demand for Insurance and Protection: The Case of Irreplaceable Commodities," The Quarterly Journal of Economics, MIT Press, vol. 91(1), pages 143-56, February.
    Full references (including those not matched with items on IDEAS)

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:dau:thesis:123456789/5064. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Alexandre Faure)

    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 references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.