The Value of Long-Term Care Insurance to Married and Single Persons

摘要 尽管一些个人和家庭在长期护理上花费了大量资金，但 美国的长期护理保险（LTCI）市场并不发达。本次活动的总体目标 项目就是要找到原因。该研究是在支出生命周期模型的背景下进行的， 涵盖与健康相关的部分，例如医疗保健自付费用、长期护理护理费用 住宅和 LTCI。将采用两种互补的建模方法：第一种构建丰富的模型 模拟模型基于初始条件的经验估计，考虑到所有财政资源 家庭和相关转变率（支出、健康、死亡率、长期护理状况）按以下因素分层 婚姻状况、性别和教育。这些估计用于模拟一个人耗尽财富的风险 死亡前，有或没有 LTCI。面临财富耗尽风险的人口比例 将 LTCI 降低到某个定义的水平以下，将提供对 LTCI 的额外需求的估计 参与者理性行事以实现福利最大化的市场。第二种建模方法 将为已婚人士和单身人士构建并估计动态规划模型。两种型号都将 用于模拟不同长期护理保险政策的影响，包括 阶级法。该研究结合了健康与退休研究的数据，包括详细的 支出数据来自其补充研究“消费和活动邮件调查”，以及新收集的 有关消费者偏好的数据，以更好地了解行为或信息障碍（例如，错误信息） 关于进入疗养院的可能性）与购买 LTCI 的关系。它还包括如何分析 个人有关医疗补助规则和私人保险的信息与个人的私人信息相互作用 有关他们自己需要长期护理的可能性的信息，以影响人们的购买决定 LTCI。这些结果与保险特征如何影响市场渗透率的估计相结合 跨亚人群设计更适合不同市场需求的保险套餐 细分市场，可能会提高使用率。

ABSTRACT Despite the very large amounts spent by some individuals and households on long-term care, the market for long-term care insurance (LTCI) in the United States is not well developed. The overall goal of this project is to find the reasons why. The research is framed in the context of life-cycle models of spending that cover such health-related components as out-of-pocket spending on health care, long-term care in nursing homes, and LTCI. Two complementary modeling approaches will be employed: the first constructs a rich simulation model based on empirical estimates of initial conditions, taking into account all financial resources of the household and relevant transition rates (spending, health, mortality, long-term care status) stratified by marital status, sex and education. These estimates are used to simulate a person's risk of exhausting wealth before death, with and without LTCI. The fraction of the population for whom the risk of exhausting wealth is reduced by LTCI below some defined level would provide an estimate of the additional demand for LTCI in a market in which the participants behaved rationally to maximize their welfare. The second modeling approach will construct and estimate a dynamic programming model for married and single persons. Both models will be used to simulate the effects of different long-term care insurance policies, including the provisions of the CLASS Act. The research combines data from the Health and Retirement Study, including the detailed spending data from its supplemental study, the Consumption and Activities Mails survey, with newly collected data on consumer preferences to better understand behavioral or informational barriers (e.g., misinformation about the probabilities of nursing-home entry) to the purchase of LTCI. It also includes analyses of how individuals' information about Medicaid rules and private insurance interacts with individuals' private information about their own likelihood of needing long-term care to influence people's decisions to purchase LTCI. These results are combined with estimates of how insurance characteristics affect market penetration across subpopulations to design insurance packages that are better matched to the needs of different market segments, potentially increasing take-up rates.