the importance of group coverage how tax policy shaped u s health insurance in 1954 the internal revenue service stipulated that employer contributions to the health insurance plans of their employees were to be excluded from employee taxable income today the tax subsidy is major feature of the u s health care market this paper examines the initial effects of the tax subsidy on the demand for health insurance using previously unexamined data from 1953 and 1958 results suggest that the tax subsidy increased the growth of group insurance particularly among union members and employed persons this is a critical effect because group insurance is not only less expensive than individual insurance but it is also easier to obtain and households with access to group health insurance are far more likely to purchase health insurance coverage than those without similar access by increasing access to group insurance the tax subsidy fostered an increase in the purchase of group health insurance by people who may not have purchased individual coverage and generated institutional change as it cemented an employment based system of group health insurance in the united states this abstract was borrowed from another version of this item

does health plan generosity enhance hospital market power we test whether the generosity of employer sponsored health insurance facilitates the exercise of market power by hospitals we construct indices of health plan generosity and the price and volume of hospital services using data from truven marketscan for 601 counties from 2001 to 2007 we use variation in the industry and union status of covered workers within a county over time to identify the causal effects of generosity although ols estimates fail to reject the hypothesis that generosity facilitates the exercise of hospital market power iv estimates show a statistically significant and economically important positive effect of plan generosity on hospital prices in uncompetitive markets but not in competitive markets our results suggest that most of the aggregate effect of hospital market structure on prices found in previous work may be coming from areas with generous plans

claim timing and ex post adverse selection many health care treatments are not urgent and may be delayed if patients so choose because insurance coverage is typically determined by the treatment date individuals may have incentives to strategically delay treatments to minimize out of pocket costs the strategic delay of treatment a particular form of moral hazard can be an important source of subsequent adverse selection in which ex ante identical individuals select insurance coverage based on their differing accumulation of previously delayed treatments this article investigates these forces empirically in the context of the missing market for dental insurance using rich claim level data my analysis reveals that approximately 40 of individuals strategically delay dental treatments when incentivized to do so and this flexibility in delaying treatment can explain why the market for dental insurance has largely unraveled more generally the counterfactual analysis suggests features such as open enrolment periods and contracting on pre existing conditions may be helpful tools in overcoming adverse selection in insurance contexts where the timing of uncertainty is not contractible

does asymmetric information matter in the early insurance market evidence from the auto insurance market in the late 1960s the performance of automobile insurance declined dramatically in japan in spite of rapid growth in the diffusion rate and the premiums were sharply raised several times in order to improve the situation this observation indicates the possible presence of adverse selection death spiral and provides an ideal situation for assessing informational asymmetry using bodily injury liability bil insurance data from 46 japanese prefectures over the period 1966 to 1975 this article tests two hypotheses of adverse selection i high risk drivers were more likely to join the bil insurance market and ii sharp premium increases drove low risk policyholders away various empirical analyses show that there is little evidence for either type of adverse selection we also test whether a risk misperception hypothesis can explain our results and find some evidence that the population density have a significantly positive impact on the demand for bil insurance an earlier version of this artic

health plan choice using a unique panel dataset of health plan choices and personal characteristics of employees at a single firm this paper provides estimates of price elasticities for health insurance plans in a managed competition setting estimated price elasticities are larger in absolute value than most previous estimates and the magnitude of the price elasticity suggests that there is a place for price competition in this market we also find evidence of transition costs in switching health plans for older and less healthy employees such differential responses to price may contribute to adverse selection in this market

do informal risk sharing networks crowd out public voluntary health insurance evidence from vietnam many governments in low income countries have promoted voluntary health insurance schemes in recent years with the principal aim of improving access to services amongst those working in the informal economy few attempts to understand demand for such schemes exist particularly in light of the importance of informal social security arrangements for many households a model of demand for health insurance is developed reflecting this context and estimated using data from vietnam the results show that informal financial networks may crowd out government promoted health insurance implications for theory and policy are discussed

the role of income and health risk in the choice of health insurance evidence from australia abstract health insurance choice is investigated using individual data from australia where all people faced a common limited set of possible health insurance policies the data cover two separate regimes one in which insurance choice was for a more generous level of coverage and one in which the choice was a more dramatic one between insurance and no insurance coverage in determining health insurance choice the results indicate a major role for income a major role for premium notably in the first regime and a minor role for observed factors related to health risk aside from age and sex

incentive effects in the demand for health care a bivariate panel count data estimation this paper contributes in three dimensions to the literature on health care demand first it features the first application of a bivariate random effects estimator in a count data setting to permit the efficient estimation of this type of model with panel data second it provides an innovative test of adverse selection and confirms that high risk individuals are more likely to acquire supplemental add on insurance third the estimations yield that in accordance with the theory of moral hazard we observe a much lower frequency of doctor visits among the self employed and among mothers of small children copyright 2002 john wiley sons ltd

equilibrium in competitive insurance markets with ex ante adverse selection and ex post moral hazard abstract existence of pure strategy equilibria is studied in health insurance markets that exhibit both ex ante adverse selection of the rothschild stiglitz wilson type and ex post hidden information moral hazard it is found that ex post moral hazard has two offsetting effects on the existence of equilibrium and that in general it is difficult to say whether an equilibrium is more or less likely to exist numerical simulations and an analytical example confirm that moral hazard may increase the likelihood of equilibrium these results are interpreted as evidence that health maintenance organization hmo markets could be less likely to exhibit stable equilibria than are fee for service insurance markets

an index of inequality with applications to horizontal equity and social mobility horizontal equity and social mobility are discussed in terms of a non utilitarian social welfare function which takes account of the process by which an ex ante distribution is mapped into an ex post distribution by the tax system for example an index of inequality is proposed which decomposes into two components corresponding to vertical and horizontal equity respectively a functional form for the social welfare function is derived for the purposes of empirical work and an application to data for 5895 uk households is presented the paper contains a theoretical application of the index to a model of optimal taxation it is conventional to assess the merits of alternative public policies in terms of a trade off between equity and efficiency in practice however a change in say the tax system involves three effects first it may have incentive or disincentive effects leading to efficiency gains or losses secondly it may alter the distribution of welfare levels thirdly it may alter the ranking of individuals or households within the distribution these three effects correspond to efficiency vertical equity and we shall argue certain aspects of horizontal equity respectively and any assessment of a tax change must take into account all three the principal assumption of this paper is that government is concerned about the trade off between these three effects a strict utilitarian is concerned only with the consequences of an action and in the evaluation of a particular reform a utilitarian measure of social welfare is defined over the vector of ex post utilities no account is taken of the process by which the vector of ex ante utilities is mapped into the ex post vector and no ethical status is awarded to the ex ante distribution one does not have to adopt an entitlement theory of justice to believe that the utilitarian approach may ignore some relevant considerations such as the fairness of the redistributive process a striking example of this arises in the model used by mirrlees 11 to examine optimal income taxation in that model individuals have identical preferences defined over consumption and leisure and differ only in respect of their potential wage rates or ability levels clearly in the absence of taxation individual utility is an increasing function of ability suppose the government uses redistributive lump sum taxes to achieve the first best optimum then as mirrlees 11 12 shows the first best optimum for a utilitarian social welfare

welfare distributional change and the measurement of social mobility a new approach to the measurement of welfare distributional change and social mobility is developed the novel feature of this model is the use of price dependent measures of individual and social welfare in evaluating t he magnitude and direction of the movement in the distribution in addition the proposed indexes of mobility are decomposed into the sum of between group and w ithin group mobility each measure is implemented for the united states over the period 1947 1982 it is found that in each year society is upwardly mobile rela tive to the 1947 distribution copyright 1986 by mit press

bankruptcy as implicit health insurance this paper examines the implicit health insurance that households receive from the ability to declare bankruptcy exploiting multiple sources of variation in asset exemption law i show that uninsured households with a greater financial cost of bankruptcy make higher out of pocket medical payments conditional on the amount of care received in turn i find that households with greater wealth at risk are more likely to hold health insurance the implicit insurance from bankruptcy distorts the insurance coverage decision using a microsimulation model i calculate that the optimal pigovian penalties are three quarters as large as the average penalties under the affordable care act

price elasticity and adverse selection in the demand for supplementary health insurance probit regression estimates show the effects of the price of insurance anticipated medical expenditures and other factors on reported decisions about purchasing hypothetically offered supplementary insurance policies the demand estimates can characterize how much supplemental insurance would be purchased under different tax policies affecting health insurance purchases although eliminating the current tax subsidy to insurance is shown to decrease demand the results indicate a substantial demand for supplementary insurance even in the absence of present tax incentives however our results on adverse selection raise concerns about the potential stability of supplemental insurance markets

impact of varying medigap insurance coverage on the use of medical services of the elderly a recursive model is estimated for the demand for medigap insurance coverage and for expected total medical care expenditures it is found that higher levels of coverage are associated with increased expenditures through higher probabilities of incurring a medical expense and increased levels of expenditures those with poor health had a smaller likelihood of having insurance than those with better health status contrary to the notion of adverse selection however those in poor health status who obtained health insurance tended to purchase more insurance coverage than those with better health status consistent with adverse selection non whites were at a disadvantage in terms of the probability of having medigap insurance and expected medical expenditures

informal groups and health insurance take up evidence from a field experiment summary this paper presents the results of 20 randomized experiments aimed at understanding the low take up of in patient health insurance observed in developing countries take up does not increase when participants receive information about the product or an assistance to register or small subsidies of 2 10 or 30 take up does not increase when the same information is provided by local respected community leaders when participants are offered an in kind gift a chicken if they register when participants are offered the possibility to contribute lower and more frequent payments or the possibility to pay by cellphone a full subsidy generates a mere 45 take up with no retention after one year in contrast to these low take up rates presenting the same information without any subsidies to existing informal groups raises take up to 12 still 7 after one year as well as trust and knowledge of the product social networks play a major role in the adoption of health insurance this paper provides a cost effective way to increase take up of health insurance while subsidies are found to be largely ineffective at raising take up in the long run

health insurance and retirement of married couples summary most health insurance in the usa is provided by employers until eligibility for public health insurance medicare begins at age 65 retiring before 65 exposes workers who lack retiree health insurance coverage to the risk of catastrophic medical expenditure we solve and estimate a dynamic model of the employment behavior of older married couples that includes risky medical expenditure and health insurance parameter estimates imply that the risk reducing feature of health insurance can account for about half of the observed association between retiree health insurance and employment for married men but can account for only one tenth of the much larger observed association for married women policy simulations imply very small effects on employment of changing the age of eligibility for medicare from 65 to 67 copyright 2006 john wiley sons ltd

the determinants of mortality mortality rates have fallen dramatically over time starting in a few countries in the 18th century and continuing to fall today in just the past century life expectancy has increased by over 30 years at the same time mortality rates remain much higher in poor countries with a difference in life expectancy between rich and poor countries of also about 30 years this difference persists despite the remarkable progress in health improvement in the last half century at least until the hiv aids pandemic in both the time series and the cross section data there is a strong correlation between income per capita and mortality rates a correlation that also exists within countries where richer better educated people live longer we review the determinants of these patterns over history over countries and across groups within countries while there is no consensus about the causal mechanisms we tentatively identify the application of scientific advance and technical progress some of which is induced by income and facilitated by education as the ultimate determinant of health such an explanation allows a consistent interpretation of the historical cross country and within country evidence we downplay direct causal mechanisms running from income to health

much ado about two reconsidering retransformation and the two part model in health econometrics in health economics applications involving outcomes y and covariates x it is often the case that the central inferential problems of interest involve e y x and its associated partial effects or elasticities many such outcomes have two fundamental statistical properties y 0 and the outcome y 0 is observed with sufficient frequency that the zeros cannot be ignored econometrically this paper 1 describes circumstances where the standard two part model with homoskedastic retransformation will fail to provide consistent inferences about important policy parameters and 2 demonstrates some alternative approaches that are likely to prove helpful in applications

a semi parametric model for asymmetric information in health plan markets i introduction there are two potential sources of asymmetric information that induce market failure in the health plan market the first adverse selection is analyzed by rothschild and stiglitz 1976 in their study individuals are exogenously assigned one of two possible illness probabilities only the individuals know their true illness probability under these conditions low risk consumers underinsure in environments where equilibrium exists adverse selection also occurs when plans can observe characteristics that affect risk but cannot adjust premiums to reflect these risks this type of adverse selection is discussed by cutler and reeber 1998 here plan premiums are constrained to be the same across all policyholders and therefore one cannot risk adjust on observable variables such as age or previous medical history similar to the first type of adverse selection the low and high risk policyholders sort themselves into different plans or plans attempt to cream skim by adjusting reimbursements that are more favorable to the profitable low risk policyholders death spirals can occur where the low risk consumers leave the more generous plans causing premiums of these plans to grow which in turn induces more members to leave these plans as the premiums grow more individuals leave the generous plan until it is no longer viable the second source of information asymmetry comes from the individual s choice of preventive effort much recent publicity has shown how individuals can reduce their probability of illnesses or accidents choices of eating drinking exercising smoking unprotected sexual activity driving behavior recreational drug use and sunscreen use are a few items from the long lists of decisions that affect the probability of illness health insurers cannot contract policyholders to exert a certain level of preventive effort because there is no mechanism to observe these efforts auto insurers can contract indirectly for effort by accessing public driving records and charging premium surcharges for traffic violations there are no counterpart records for health plans arnott and stiglitz 1988 and pauly 1974 discuss the welfare effects when preventive effort can reduce illness probabilities but the level of these efforts cannot be monitored and therefore cannot be written into a contract when this condition occurs full insurance is no longer feasible because no effort would be exerted under full insurance because health plans are not compensating individuals for the cost savings that come from preventive effort the individual s choice of effort is usually less than optimal therefore we call this information asymmetry moral hazard this moral hazard results in underinsurance for the entire population stewart 1994 looks at an economy where both adverse selection and moral hazard are present he finds that the welfare losses coming from both sources are subadditive i e the total welfare loss is less than the sum of the losses coming from both yet when both moral hazard and adverse selection are present the economy is still worse off by having both sources of asymmetric information instead of one of them in most of his simulations the low risk types substitute preventive effort for income protection although this is not a theoretically proven result his study shows that it is difficult to derive general results on the misallocation of effort and risk sharing when both sources are present because these misallocations depend on the individual s willingness to substitute the income savings from effort for the income protection that comes from insurance setting good health care policy requires knowing about the presence of these informational asymmetries unfortunately to date there is no consensus about the presence of informational asymmetries that come from either adverse selection or preventive effort most studies have attempted to determine only if adverse selection is present while ignoring the possible existence of preventive effort

physician payments under health care reform abstract this study examines the impact of major health insurance reform on payments made in the health care sector we study the prices of services paid to physicians in the privately insured market during the massachusetts health care reform the reform increased the number of insured individuals as well as introduced an online marketplace where insurers compete we estimate that over the reform period physician payments increased at least 11 percentage points relative to control areas payment increases began around the time legislation passed the house and senate the period in which their was a high probability of the bill eventually becoming law this result is consistent with fixed duration payment contracts being negotiated in anticipation of future demand and competition

differences and similarities between ecological and economic models for biodiversity conservation abstract in this paper we investigate an important obstacle which substantially complicates co operation between ecologists and economists but which has received little attention so far differences between the modelling approaches in economics and ecology to understand these differences 60 models addressing issues relevant to biodiversity conservation have been selected randomly from eight international economic and ecological journals the models have been compared according to a number of criteria including the models level of generality the mathematical techniques employed for formulation and solution of the models the level of complexity and the way time space and uncertainty are taken into account the economic models sampled are formulated and analysed analytically tend to be relatively simple and are mostly used to investigate general questions furthermore they often ignore space dynamics and uncertainty although some ecological models have similar properties there is also a substantial number of another type of ecological models that are relatively complex and analysed by simulation these models tend to be rather specific and often explicitly consider dynamics space and uncertainty the integrated ecological economic models are observed to lie in the middle between ecological and economic models an unexpected result is that they are not more complex than ecological and economic models as one could have expected from a simple merger of models from both disciplines but have an intermediate complexity

the meaning and measurement of income mobility abstract income mobility may be seen as arising from two sources i the transfer of income among individuals with total income held constant and ii a change in the total amount of income available in this paper we propose several sensible properties defining the concept of income mobility and show that an easily applicable measure of mobility is uniquely implied by these properties we also show that the resulting measure is additively decomposable into the two sources listed above namely mobility due to the transfer of income within a given structure and mobility due to economic growth or contraction finally these results are compared and contrasted with other mobility concepts and measures in the literature journal of economic literature classification numbers d31 d63

making inferences from controlled income maintenance experiments nationally this paper addresses a question whose answer is essential for interpreting the results of such experiments if an experiment of limited duration is conducted under ideal conditions what can be inferred from the experimental results about behavior in a world where nit is adopted permanently by ideal conditions we mean that a individuals or households 2 in the experiment are conventional utility maximizers given the structure of the experiment and b the experiment is sufficiently well designed to permit the differential responses of individuals to be identified 3 the

shifted deductibles for high risks more effective in reducing moral hazard than traditional deductibles in health insurance a traditional deductible i e with a deductible range 0 d is in theory not effective in reducing moral hazard for individuals who know ex ante that their expenditures will exceed the deductible amount d e g those with a chronic disease to increase the effectiveness this paper proposes to shift the deductible range to si si d with starting point si depending on relevant risk characteristics of individual i in an empirical illustration we assume the optimal shift to be such that the variance in out of pocket expenditures is maximized results indicate that for the 10 percent highest risks in our data the optimal starting point of a 1000 deductible is to be found far beyond 1200 which corresponds with a deductible range of 1200 2200 or further we conclude that compared to traditional deductibles shifted deductibles with a risk adjusted starting point lower out of pocket expenditures and may further reduce moral hazard

health insurance and the demand for medical care evidence from a randomized experiment we estimate how cost sharing the portion of the bill the patient pays affects the demand for medical services the data come from a randomized experiment a catastrophic insurance plan reduces expenditures 31 percent relative to zero out of pocket price the price elasticity is approximately 0 2 we reject the hypothesis that less favorable coverage of outpatient services increases total expenditure for example by deterring preventive care or inducing hospitalization

patient cost sharing in low income populations economie theory suggests that a natural tool to control medical costs is increased consumer cost sharing for medical care while such cost sharing reduces full insurance wherein patients are indifferent between falling sick or remaining healthy a greater reliance on coinsurance and copayments can in theory stem patient and provider incentives to engage

adverse selection moral hazard and wealth effects in the medigap insurance market using data from a longitudinal study of the recently retired we attempt to separate the moral hazard effect of medicare supplementary medigap insurance on health care expenditures from the adverse selection effect of poor health on medigap coverage we find evidence of adverse selection but its magnitude is unlikely to create serious efficiency problems taking adverse selection into account reduces the estimate of the moral hazard effect in addition we find a strong positive wealth effect on the demand for supplementary insurance

incentive contracts for natura 2000 implementation in forest areas the implementation of nature conservation policy is often based on contracts between public authorities and landowners in this article we model incentive contracts in forest areas in the presence of adverse selection and moral hazard when the conservation outcome is uncertain ex ante but observable ex post the results show that agents who are likely to achieve a higher level of conservation should be offered a contract where transfers depend on the final outcome with a bonus for a high ecological level of the forest when conservation measures are correlated with forest management we show that the contractual measures involve distorted transfers we analyse the payment mechanisms used in france and denmark in the context of the natura 2000 policy these mechanisms result in overcompensation and under performance since they do not take the problem of moral hazard and natural variability into account

public policy and health insurance choices of the elderly evidence from the medicare buy in program this study provides evidence on health insurance decisions of senior citizens nearly all senior citizens have health insurance coverage through medicare but poor seniors may also qualify for medicaid that fills many gaps in medicare coverage since 1987 the medicaid program has expanded eligibility using the sipp i find that medicaid eligibility increased from 8 7 in 1987 to 12 4 in 1995 for every 100 elderly who became eligible approximately 50 took up medicaid but more than 30 dropped private coverage resulting in crowd out of 60 crowd out came from individuals dropping privately purchased health insurance rather than dropping employer provided retiree health insurance the roles of asset tests health status and the panel structure of the sipp are also explored i find that a major strength of the sipp is in its point in time asset information for determining medicaid eligibility while the changing income and demographic information over the course of the 2 year panel adds little insight beyond cross sectional data 2000 elsevier science s a all rights reserved

an econometric model of health care utilization and health insurance in switzerland abstract this paper presents a preliminary econometric analysis on how different alternative plans affect the utilization of health care services in switzerland the data come from the 1992 1993 swiss health survey shs we briefly describe some institutional aspects of the swiss health system which prevailed at the time of the shs with particular emphasis on health insurance plans and payment system of providers we estimate a simultaneous two equation model containing latent variables in order to compare the probability of having at least one inpatient stay given that the insured has used some medical treatment for those who have purchased only a basic insurance plan and those who have purchased a supplemental insurance

demand for medical care by the elderly a finite mixture approach summary in this article we develop a finite mixture negative binomial count model that accommodates unobserved heterogeneity in an intuitive and analytically tractable manner this model the standard negative binomial model and its hurdle extension are estimated for six measures of medical care demand by the elderly using a sample from the 1987 national medical expenditure survey the finite mixture model is preferred overall by statistical model selection criteria two points of support adequately describe the distribution of the unobserved heterogeneity suggesting two latent populations the healthy and the ill whose fitted distributions diaer substantially from each other 1997 by john wiley sons ltd

development of ecological economics in australia and new zealand abstract this paper reviews the development of ecological economics in australia and new zealand since its beginnings in the late 1970s a historical account is presented that focuses particularly on the activities of the australia new zealand society for ecological economics and key ecological economics research activities achievements of ecological economics in australia and new zealand are assessed using a range of quantitative and qualitative data the main areas of expertise developed by australian and new zealand ecological economists were found to be theoretical foundations and visions for ecological economics biodiversity and resilience input output analysis heterodox valuation approaches analysis of economy environment interactions sustainability indicators sustainable agriculture fisheries and oceans and energy thermodynamics both countries are ranked at the top or near the top of the world rankings in terms of per capita isee membership and publication rates in ecological economics a defining feature of ecological economics in australia and new zealand has also been its practical and problem solving focus and the level of end user engagement the paper concludes by discussing the challenges that face the future development of ecological economics in australia and new zealand

sticker shocks using vat changes to estimate upper level elasticities of substitution we estimate the upper level elasticity of substitution between goods and services of a nested aggregate ces preference specification we show how this elasticity can be derived from the long run response of the relative price of a good to a change in its vat rate we estimate this elasticity using new data on changes in vat rates across 74 goods and services for 25 european union countries from 1996 through 2015 depending on the level of aggregation we find a vat pass through rate between 0 4 and 0 7 this implies an upper level elasticity of 3 at the lowest level of aggregation with 74 categories and 1 cobb douglas preferences at a high level of aggregation that distinguishes 10 categories of goods and services

estimating welfare in insurance markets using variation in prices we provide a graphical illustration of how standard consumer and producer theory can be used to quantify the welfare loss associated with inefficient pricing in insurance markets with selection we then show how this welfare loss can be estimated empirically using identifying variation in the price of insurance such variation together with quantity data allows us to estimate the demand for insurance the same variation together with cost data allows us to estimate how insurers costs vary as market participants endogenously respond to price the slope of this estimated cost curve provides a direct test for both the existence and the nature of selection and the combination of demand and cost curves can be used to estimate welfare we illustrate our approach by applying it to data on employerprovided health insurance from one specific company we detect adverse selection but estimate that the quantitative welfare implications associated with inefficient pricing in our particular application are small in both absolute and relative terms

rational behavior in the presence of coverage ceilings and deductibles consumers of health care services with insurance plan features such as deductibles copayments and coverage ceilings in which the price of health care depends upon expenditures accumulated during a single year should rationally anticipate the impact of current consumption decisions on the price of health care later in the year we show that in the absence of wealth effects and risk aversion a utility maximizing consumer should base current consumption decisions on the expected end of year price of health care in a specific model with risk aversion and lumpy consumption decisions we show that the expected end of year price remains close to the true shadow price of health carefor plausible insurance plan and demand parameters we use this result in an econometric model of the demand for ambulatory mental health services

more on the economic efficiency of mixed public private insurance abstract blomqvist and johansson 1996 criticize my results regarding besley s besley 1989 analysis of public catastrophic coverage they concede that my analysis was correct under the assumptions i made but they argue that a more general model than besley or i used might yield different results unfortunately blomqvist and johansson s analysis of the more general case is flawed whereas they claim to have provided a more general argument against the sort of public intervention besley proposed they have unwittingly discovered an example in which his original conjecture holds

tax policy and the demand for health insurance estimates of the price and income elasticities of demand for health insurance are derived from econometric estimates of the parameters of a discrete choice model of health insurance demand using data from a survey of plan choices among a sample of federal government employees the estimated income elasticity 0 01 is similar to most previous estimates the estimated price elasticity 0 16 is in absolute value much less than the earlier previous estimates and somewhat less than the more recent previous estimates possible causes of these differences in price elasticity estimates are discussed

health insurance the tradeoff between risk pooling and moral hazard choosing optimal health insurance coverage involves a trade off between the gain from risk reduction and the deadweight loss from moral hazard this paper examines this trade off empirically by estimating both the demand for health insurance and the demand for health services it relies on data from a randomized controlled trial of cost sharing s effects on the use of health services and on the health status for a general non elderly population

species conservation and the principal agent problem abstract principal agent problems occur in contract or management contexts they arise out of the agent s desire to imperfectly follow the principal s preferences despite being under the authority of the principal principal agent problems may be present in biodiversity recovery programmes a principal agent model is constructed where rewards and sanctions are based on the change in a species status an optimal contract is derived but it is then argued that this contract will be impossible to implement principal agent problems may impose costs to recovery programmes both in terms of lower odds of persistence and the mix of species prioritised three institutional devices ecosystem management agent selection mechanisms and attaching economic returns to the change in species status may offset some of these costs

the normative economics of health care finance and provision whereas in many countries the crisis in medical care has been seen in terms of excess spending on health services in the uk it has been seen at least by most of those who manage and work in the nhs as a crisis of underfunding this has come about as the result of the government s successful attempts to restrain the rate of growth of real spending on the nhs which in turn reflects the government s belief that its principal effective weapon against what it perceives to be inefficiency in the nhs is to challenge management itself reformed and to some extent liberated by systematic financial squeezes the same concern has given rise to a host of proposals for reform of the nhs most of which involve a much greater role for private insurance private finance of other kinds such as out of pocket payments and private provision of health care itself

a comparison of alternative models for the demand for medical care we have tested alternative models of the demand for medical care using experimental data the estimated response of demand to insurance plan is sensitive to the model used we therefore use a split sample analysis and find that a model that more closely approximates distributional assumptions and uses a nonparametric retransformation factor performs better in terms of mean squared forecast error simpler models are inferior either because they are not robust to outliers e g anova anocova or because they are inconsistent when strong distributional assumptions are violated e g a two parameter box cox transformation

optimal departures from marginal cost pricing focuses on departures from marginal cost pricing optimal allocation or resources level of tax revenue that will be collected by the government theorems developed for resource allocation ebsco

demand for medigap insurance by the elderly a micro simulation analysis in this paper a micro simulation model is developed to explain and estimate the optimum medigap insurance coverage for elderly with different levels of insurance premium subsidy the medigap risk exposure is estimated from the 1977 national medical care expenditure utilization survey utilizing the gamma distribution the theory of expected utility maximization is assumed and the model for health insurance demand is operationalized for hypothetical parameters for risk aversion the price elasticity of demand the loading fee and the subsidy with the risk aversion parameter at 0 0005 the price elasticity of medical care demand at 0 5 loading costs at 9 without any subsidy the optimal medigap coinsurance rate is 0 78 and with a premium subsidy of 60 the co insurance rate falls to 12 the hypothetical price elasticity of demand for medigap insurance is estimated to be between 0 44 and 1 02 more than half of the increase in medical expenditure resulting from an increase in premium subsidy from