Measuring Welfare Losses from Adverse Selection and Imperfect Competition in Privatized Medicare
Measuring Welfare Losses from Adverse Selection and Imperfect Competition in Privatized Medicare
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衡量私有化医疗保险中逆向选择和不完全竞争造成的福利损失
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发表时间：
2009
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通讯作者：
Joshua Lustig
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作者：
Joshua Lustig
本文衡量了私有化医疗保险中逆向选择和不完全竞争造成的福利损失。我在一个环境中对保险公司的保费和承保范围选择进行建模，在这种环境中，具有不同偏好的消费者可能会给保险公司带来不同的成本。利用保险公司的行为和市场结构的外生变化，我确定了消费者类型和保险公司成本之间的因果关系，并推断决定保险需求的偏好是否包含有关预期健康的信息。结果表明逆向选择确实存在。没有逆向选择的模拟均衡表明，由此产生的福利损失是巨大的，占总支出的 8.1%，但比不完全竞争造成的损失要小。波士顿大学经济系，270 Bay State Road, Boston, MA 02215； jlustig@bu.edu； http://people.bu.edu/jlustig/
This paper measures welfare losses caused by adverse selection and imperfect competition in privatized Medicare. I model insurers premium and coverage choices in an environment where consumers with heterogeneous preferences may impose di¤erent costs on their insurers. Using insurers behavior and exogenous variation in market structure, I identify a causal link between consumerstypes and insurers costs and infer whether preferences, which determine insurance demand, contain information about expected health. The results suggest adverse selection is indeed present. Simulated equilibria without adverse selection suggest the resulting welfare losses are substantial, 8.1% of total spending, but are smaller than those caused by imperfect competition. Department of Economics, Boston University, 270 Bay State Road, Boston, MA 02215; jlustig@bu.edu; http://people.bu.edu/jlustig/