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Optimal Long-Term Health Insurance Contracts: Characterization, Computation, and Welfare Effects

Author

Listed:
  • Soheil Ghili

    (Cowles Foundation, Yale University)

  • Ben Handel

    (Department of Economics, UC Berkeley)

  • Igal Hendel

    (Department of Economics, Northwestern University)

  • Michael D. Whinston

    (Department of Economics and Sloan School of Management, M.I.T)

Abstract

Reclassification risk is a major concern in health insurance where contracts are typically one year in length but health shocks often persist for much longer. While most health systems with private insurers emphasize short-run contracts paired with substantial pricing regulations to reduce reclassification risk, long-term contracts with one-sided insurer commitment have significant potential to reduce reclassification risk without the negative side effects of price regulation, such as adverse selection. In this paper, we theoretically characterize optimal long-term insurance contracts with one-sided commitment, extending prior models of this form in several key directions that are important for studying health insurance markets. We leverage this characterization to provide a simple algorithm for computing optimal contracts from primitives. We estimate key market fundamentals using data on all under-65 privately insured consumers in Utah and pair these estimates with our model to study comparative statics related to contract design and welfare. We find that the welfare value of a system that effectively implements these long-term contracts depends crucially on (i) the degree of public insurance pre-system health risk (ii) the distribution of expected lifetime income gradients in the population (iii) the stochastic process governing life-cycle health shocks (iv) the extent of consumer switching costs and (v) the degree of consumer myopia.

Suggested Citation

  • Soheil Ghili & Ben Handel & Igal Hendel & Michael D. Whinston, 2019. "Optimal Long-Term Health Insurance Contracts: Characterization, Computation, and Welfare Effects," Cowles Foundation Discussion Papers 2218R2, Cowles Foundation for Research in Economics, Yale University, revised May 2021.
  • Handle: RePEc:cwl:cwldpp:2218r2
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    References listed on IDEAS

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    Cited by:

    1. Vitor Farinha Luz, 2022. "Optimal dynamic insurance contracts," Papers 2208.14560, arXiv.org.
    2. Shiv Dixit, 2023. "Contract Enforcement and Preventive Healthcare: Theory and Evidence," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 51, pages 1048-1094, December.

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    More about this item

    JEL classification:

    • L5 - Industrial Organization - - Regulation and Industrial Policy
    • I1 - Health, Education, and Welfare - - Health
    • D0 - Microeconomics - - General

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