Why Doesn't the Market Fully Insure Long-Term Care?
Why Doesn't the Market Fully Insure Long-Term Care?
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为什么市场不能充分保障长期护理？
DOI：
10.3386/w4301
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发表时间：
1993
期刊：
影响因子：
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通讯作者：
David M. Cutler
中科院分区：
文献类型：
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作者：
David M. Cutler
本文探讨了私人市场的失败，以充分确保长期护理。我认为，失败是长期护理成本存在巨大跨期差异的结果。与横截面使用的可变性不同，护理成本的可变性影响到池中的每个人，因此不能在队列中多样化。此外，由于成本是连续相关的，成本风险不能在不同的群组之间分散。估计表明，平均长期护理政策的成本不确定性的标准差约为4%至14%。为了应对这种成本风险，大多数长期护理政策并不保证真实的利益。保单通常支付固定的护理名义金额，该金额使用预定的名义规则进行更新。许多保单还规定了终身最高赔付额和其他对承保人承担总风险的限制。缺乏完整的长期护理保险可能是长期护理保单购买率低的一个解释。
This paper examines the failure of the private market to fully insure long-term care. I argue that the failure is a result of large intertemporal variability in the cost of long-term care. Unlike variability in cross section use, variability in the cost of care affects everyone in a pool and therefore cannot be diversified within a cohort. Further, since costs are serially correlated, the cost risk cannot be diversified across cohorts. Estimates suggest that the standard deviation of cost uncertainty is on the order of 4 to 14 percent for an average long-term care policy. In response to this cost risk, most long-term care policies do not insure real benefits. Policies generally pay a fixed nominal amount for care, which is updated using predetermined nominal rules. Many policies also have lifetime maximum payments and other restrictions on aggregate risk bearing by the insurer. The lack of complete long-term care insurance may be one explanation for the low rate of purchase of long-term care policies.