Moral hazard under zero price policy: evidence from Japanese long-term care claims data
Moral hazard under zero price policy: evidence from Japanese long-term care claims data
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DOI：
10.1007/s10198-019-01041-6
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发表时间：
2019-08-01
影响因子：
4.4
通讯作者：
Noguchi, Haruko
中科院分区：
文献类型：
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作者：
Fu, Rong;Noguchi, Haruko
我们评估日本公共长期护理保险（LTCI）市场中道德风险的存在和程度。使用从2006年1月到2015年12月的每月LTCI索赔记录与并发死亡记录相关联，我们构建了一个样本，通过倾向评分匹配共同支付10%费用的投保人与不需要共同支付费用的投保人，我们实现了固定效应估计。我们发现，共同负担率降低10个百分点，每月成本增加1.02万日元，对应的价格弹性约为-0.1。没有自付额的投保人往往比有自付额的人使用更多的服务，使用天数也更多。此外，我们发现，投保人谁死于脑（心肌）梗死增加他们的服务使用更多的响应减少的自付率比那些死于衰老，表明事前的健康风险和事后的服务使用之间的正相关。我们证实，费用分摊调整是一个有效的解决方案飙升的长期成本倡议支出。这些发现可以为快速老龄化的世界提供广泛的影响。
We evaluate the presence and magnitude of moral hazard in Japan's public long-term care insurance (LTCI) market. Using monthly LTCI claim records from January 2006 to December 2015 linked to concurrent death records, we construct a sample by propensity score matching insured individuals who co-pay 10% of their fees to those with no required copayments, and we implement fixed-effect estimations. We find that a ten-percentage-point reduction in the copayment rate increases monthly costs by 10.2 thousand yen, corresponding to a price elasticity of about - 0.1. Insured individuals with no copayments tend to use more services and have more utilization days than those with copayments do. Furthermore, we find that insured individuals who die from cerebral (myocardial) infarction increase their service use more in response to a reduction in the copayment rate than those who die from senility do, indicating a positive association between ex-ante health risks and ex-post service use. We verify that a cost-sharing adjustment is a valid solution for soaring LTCI expenditures. These findings could provide broad implications for the rapidly aging world.