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International Portability of Health-Cost Cover: Mobility, Insurance, and Redistribution

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  • Martin Werding
  • Stuart McLennan

Abstract

Public health insurance and other arrangements covering health-costs effectively provide insurance against changes in health status. These arrangements engage in burden-smoothing over the life cycle and entail various elements of redistribution. Lack of portability regarding this type of cover may impede international mobility and create financial losses or windfall gains on various sides, which can lead to risk segmentation across national health systems. Existing portability rules do not fully address these problems. In this paper, we try to clarify the implications of mobility for typical systems covering health costs and the requirements which have to be met to ensure full portability. When individuals are internationally mobile, compensating payments are needed based on changes in expected net costs in both of the health funds involved. Illustrative simulations show that this approach may be operative under real-world conditions.

Suggested Citation

  • Martin Werding & Stuart McLennan, 2012. "International Portability of Health-Cost Cover: Mobility, Insurance, and Redistribution," CESifo Working Paper Series 3952, CESifo Group Munich.
  • Handle: RePEc:ces:ceswps:_3952
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    File URL: http://www.cesifo-group.de/DocDL/cesifo1_wp3952.pdf
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    References listed on IDEAS

    as
    1. Werding, Martin & McLennan, Stuart, 2011. "International portability of health-cost coverage : concepts and experience," Social Protection and Labor Policy and Technical Notes 63929, The World Bank.
    2. Jonathan Gruber & Brigitte C. Madrian, 2002. "Health Insurance, Labor Supply, and Job Mobility: A Critical Review of the Literature," JCPR Working Papers 255, Northwestern University/University of Chicago Joint Center for Poverty Research.
    3. Volker Meier, 2005. "Efficient Transfer of Aging Provisions in Private Health Insurance," Journal of Economics, Springer, vol. 84(3), pages 249-275, May.
    4. Florian Baumann & Volker Meier & Martin Werding, 2008. "Transferable Ageing Provisions in Individual Health Insurance Contracts," German Economic Review, Verein für Socialpolitik, vol. 9, pages 287-311, August.
    5. Munz, Sonja & Werding, Martin, 2005. "Public pensions and international migration: some clarifications and illustrative results," Journal of Pension Economics and Finance, Cambridge University Press, vol. 4(02), pages 181-207, July.
    6. Holzmann, Robert & Koettl, Johannes, 2011. "Portability of pension, health, and other social benefits : facts, concepts, issues," Social Protection and Labor Policy and Technical Notes 62725, The World Bank.
    7. Herring, Bradley & Pauly, Mark V., 2006. "Incentive-compatible guaranteed renewable health insurance premiums," Journal of Health Economics, Elsevier, vol. 25(3), pages 395-417, May.
    8. Wei Sun & Anthony Webb & Natalia Zhivan, 2009. "Does Staying Healthy Reduce Your Lifetime Health Care Costs?," Issues in Brief ib2010-8, Center for Retirement Research, revised May 2009.
    9. Wido Geis & Silke Uebelmesser & Martin Werding, 2013. "How do Migrants Choose Their Destination Country? An Analysis of Institutional Determinants," Review of International Economics, Wiley Blackwell, vol. 21(5), pages 825-840, November.
    10. Robert Fenge & Silke Uebelmesser & Martin Werding, 2006. "On the Optimal Timing of Implicit Social Security Taxes Over the Life Cycle," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 62(1), pages 68-107, March.
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    12. Hans-Werner Sinn, 2004. "The New Systems Competition," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 5(1), pages 23-38, February.
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    Cited by:

    1. Taha, N. & Messkoub, M. & Siegmann, K.A., 2013. "How portable is social security for migrant workers?," ISS Working Papers - General Series 50162, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.

    More about this item

    Keywords

    social insurance; health costs; migration; international portability; fiscal externalities; risk segmentation;

    JEL classification:

    • F22 - International Economics - - International Factor Movements and International Business - - - International Migration
    • F55 - International Economics - - International Relations, National Security, and International Political Economy - - - International Institutional Arrangements
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H73 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Interjurisdictional Differentials and Their Effects
    • J60 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - General

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