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Long-Term Health Insurance: Theory Meets Evidence

Author

Listed:
  • Juan Pablo Atal

    (University of Pennsylvania)

  • Hanming Fang

    (University of Pennsylvania)

  • Martin Karlsson

    (CINCH, University of Duisburg-Essen)

  • Nicolas R. Ziebarth

    (Cornell University)

Abstract

To insure policyholders against contemporaneous health expenditure shocks and future reclassification risk, long-term health insurance constitutes an alternative to community-rated short-term contracts with an individual mandate. Relying on unique claims panel data from a large private insurer in Germany, we study a real-world long-term health insurance application with a life-cycle perspective. We show that German long-term health insurance (GLTHI) achieves substantial welfare gains compared to a series of risk-rated short-term contracts. Although, by its simple design, the premium setting of GLTHI contract departs significantly from the optimal dynamic contract, surprisingly we only find modest welfare differences between the two. Finally, we conduct counterfactual policy experiments to illustrate the welfare consequences of integrating GLTHI into a system with a “Medicare-like†public insurance that covers people above 65.

Suggested Citation

  • Juan Pablo Atal & Hanming Fang & Martin Karlsson & Nicolas R. Ziebarth, 2020. "Long-Term Health Insurance: Theory Meets Evidence," CINCH Working Paper Series 2001, Universitaet Duisburg-Essen, Competent in Competition and Health.
    • Handle: RePEc:duh:wpaper:2001
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    Citations

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    Cited by:

    1. Soheil Ghili & Ben Handel & Igal Hendel & Michael D. Whinston, 2019. "The Welfare Effects of Long-Term Health Insurance Contracts," Cowles Foundation Discussion Papers 2218, Cowles Foundation for Research in Economics, Yale University.
    2. Bauer, Daniel & Lakdawalla, Darius & Reif, Julian, 2025. "Health risk and the value of life," Journal of Public Economics, Elsevier, vol. 245(C).
    3. repec:ajt:wcinch:73382 is not listed on IDEAS
    4. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    5. Sebastián Fleitas & Gautam Gowrisankaran & Anthony Lo Sasso, 2018. "Reclassification Risk in the Small Group Health Insurance Market," NBER Working Papers 24663, National Bureau of Economic Research, Inc.
    6. Avdic, Daniel & Decker, Simon & Karlsson, Martin & Salm, Martin, 2024. "No-claim refunds and healthcare use," Journal of Public Economics, Elsevier, vol. 230(C).
    7. Daniel Gottlieb & Xingtan Zhang, 2021. "Long‐Term Contracting With Time‐Inconsistent Agents," Econometrica, Econometric Society, vol. 89(2), pages 793-824, March.
    8. 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.
    9. 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.
    10. Fischer, Martin & Karlsson, Martin & Prodromidis, Nikolaos, 2021. "The Long-Term Effects of Hospital Deliveries," IZA Discussion Papers 14562, Institute of Labor Economics (IZA).

    More about this item

    Keywords

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    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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