Market Failure, Public Policy & Long Term Care Insurance

描述（由申请人提供）：本研究的目的是实证分析私人长期护理保险市场的需求和供应的决定因素。长期护理是美国老年人面临的最大的无保险财务风险之一。这也是目前医疗保险覆盖范围中最大的缺口之一，因此很可能成为关于医疗保险改革讨论的前沿。然而，我们几乎没有经验证据表明私人长期护理保险市场极度不发达的原因。因此，拟议的研究涉及几个互补的项目，旨在了解私人保险市场的运作，从而替代潜在的公共政策干预的可能影响。该分析将使用关于老年人长期护理保险覆盖率的调查数据，以及关于长期护理保险政策定价和被保险人和一般人群风险特征的广泛数据。它还需要开发两个互补的分析工具：一个评估私人长期护理保险政策的“金钱价值”的框架，以及一个估计长期护理保险合同对风险厌恶的生命周期消费者的保险价值的框架。使用这些工具，拟议的研究将调查目前的价格是否为潜在消费者提供了良好的价值，以及定价结构是否可以解释为什么很少有人购买长期护理保险。它将研究通过医疗补助提供的公共保险在多大程度上限制了对长期护理保险的需求。它还将考虑这个市场是否存在信息不对称问题，以及这些问题是否对目前市场规模有限有重大影响。最后，拟议的研究将调查为什么现有的政策提供如此有限的覆盖面，特别是这是否是一个原因或私人保险需求有限的后果。回答这些问题是考虑私营长期护理保险市场任何政策干预措施的最佳设计的必要的第一步。

DESCRIPTION (provided by applicant): The goal of this research is to analyze empirically the determinants of demand and supply in the private long-term care insurance market. Long-term care represents one of the largest uninsured financial risks facing the elderly in the United States. It is also one of the largest gaps in current Medicare coverage, and is therefore likely to be at the forefront of discussions about Medicare reform. Yet we have virtually no empirical evidence on the reasons for the extremely underdeveloped nature of the private long-term care insurance market. The proposed research therefore involves several complementary projects designed to understand the workings of the private insurance market, and hence the likely impact of alternative potential public policy interventions. The analysis will use both survey data on the elderly's long-term care insurance coverage, as well as extensive data on the pricing of long-term care insurance policies and the risk characteristics of the insured and the general population. It will also require the development of two complementary analytical tools: a framework for assessing the "money's worth" of private long-term care insurance polices, and a framework for estimating the insurance value of a long-term care insurance contract for a risk averse, life-cycle consumer. Using these tools, the proposed research will investigate whether current prices deliver good value to potential consumers, and whether the pricing structure can explain why so few people buy long-term care insurance. It will examine the extent to which the public insurance provided through Medicaid limits the demand for long-term care insurance. It will also consider whether asymmetric information problems exist in this market and whether they contribute substantially to the current limited size of the market. Finally, the proposed research will investigate why existing policies offer such extremely limited coverage and in particular whether this is a cause or consequence of limited demand for private insurance. Answers to these questions are a necessary first step to considering the optimal design of any policy interventions in the private long-term care insurance market.