Subscribing to Supplemental Health Insurance in France: A Dynamic Analysis of Adverse Selection

Adverse selection, which is well described in the theoretical literature on insurance, remains relatively difficult to study empirically. The traditional approach, which focuses on the binary decision of “covered” or “not”, potentially misses the main effects because heterogeneity may be very high among the insured. In the French context, which is characterized by universal but incomplete public health insurance (PHI), we study the determinants of the decision to subscribe to supplemental health insurance (SHI) in addition to complementary health insurance (CHI). This work permits to analyze health insurance demand at the margin. Using a panelized dataset, we study the effects of both individual state of health, which is measured by age and previous individual health spending, and timing on the decision to subscribe. One striking result is the changing role of health risk over time, illustrating that adverse selection occurs immediately after the introduction of SHI. After the initial period, the effects of health risks (such as doctors’ previous health expenditures) diminish over time and financial risks (such as dental and optical expenses and income) remain significant. These results may highlight the inconsistent effects of health risks on the demand for insurance and the challenges of studying adverse selection.Supplemental health insurance, adverse selection, health insurance demand, longitudinal analysis.

Protocol for the assessment of viral retention capability of membranes

A series of experiments has been carried out to determine the Log removal value (LRV) of MS2 bacteriophages suspended in various buffers (osmosed water, tap water, aqueous solutions of NaCl and phosphate buffer solution) during filtration through hollow fiber membranes made of cellulose acetate. Viral concentrations in permeate and retentate were determined using two different methods, namely plaque forming unit (PFU) counting, which reveals only infectious particles and quantitative RT-PCR which detects the total (infectious + inactivated) number of viral genomes regardless of their infectivity.From this experimental study, we propose guidelines for preparing the challenging solutions and measuring their concentration which ensure a reliable assessment of the membrane performance

The Likely Effects of Employer-Mandated Complementary Health Insurance on Health Coverage in France

In France, access to health care greatly depends on having a complementary health insurance coverage (CHI). Thus, the generalisation of CHI became a core factor in the national health strategy created by the government in 2013. The first measure has been to compulsorily extend employer-sponsored CHI to all private sector employees on January 1st, 2016 and improve its portability coverage for unemployed former employees for up to 12 months. Based on data from the 2012 Health, Health Care and Insurance survey, this article provides a simulation of the likely effects of this mandate on CHI coverage and related inequalities in the general population by age, health status, socio-economic characteristics and time and risk preferences. We show that the non-coverage rate that was estimated to be 5% in 2012 will drop to 4% following the generalisation of employer-sponsored CHI and to 3.7% after accounting for portability coverage. The most vulnerable populations are expected to remain more often without CHI whereas non coverage will significantly decrease among the less risk averse and the more present oriented. With its focus on private sector employees, the policy is thus likely to do little for populations that would benefit most from additional insurance coverage while expanding coverage for other populations that appear to place little value on CHI

Health status, Neighbourhood effects and Public choice: Evidence from France

Observation of socioeconomic statistics between different neighbourhoods highlights significant differences for economic indicators, social indicators and health indicators. The issue faced here is determining the origins of health inequalities: individual effects and neighbourhood effects. Using National Health Survey and French census data from the period 2002-2003, we attempt to measure the individual and collective determinants of Self-Reported Health Status (SRH). By using a principal component analysis of aggregated census data, we obtain three synthetic factors called: "economic and social condition", "mobility" and "generational" and show that these contextual factors are correlated with individual SRHs. Since the 80s, different French governments have formulated public policies in order to take into account the specific problems of disadvantaged and deprived neighbourhoods. In view to concentrating national assistance, the French government has created "zones urbaines sensibles" (ZUS) [Critical Urban Areas, CUA]. Our research shows that in spite of implementing public policy in France to combat health inequalities, by only taking into account the CUA criterion (the fact of being in a CUA or not), many inequalities remain ignored and thus hidden.Health, Neighbourhood Effect, Housing policy

Réseaux sociaux, discussions instantanées, jeux en ligne; quel temps reste-t-il pour les devoirs ?

Les outils de communication modernes occupent une place prépondérante au sein de notre société. Nos élèves sont aussi touchés par ce phénomène et ils engagent un temps considérable dans ces outils. Quels sont ces outils de communication ? Qui les utilisent ? Combien de temps passent-ils sur ces outils ? Qu’y font-ils ? Afin de répondre à ces questions, j’ai commencé par m’informer sur le sujet. Puis ayant acquis un certain bagage, j’ai mené une recherche pratique au sein de deux classes. J’ai distribué des questionnaires à ces élèves puis je les ai privés de tout outil durant une semaine. Après cela, j’ai redistribué un questionnaire afin de comparer leur attitude face aux outils de communication avant, et après avoir été privés de ces outils. Cette recherche a été très intéressante. Elle m’a permis de trouver les réponses à mes interrogations

Incertitude de la mesure de terrain en géomorphologie littorale. Approche statistique et quantification des marges d'erreur

479 p.Un des objectifs de la mesure en géomorphologie littorale est d'étudier de façon diachronique les changements morphosédimentaires d'un environnement côtier. La période d'observation et la fréquence des relevés dépendent du but recherché. On choisira une haute fréquence (relevé hebdomadaire) lorsque la problématique est d'analyser le rôle des épisodes à forte récurrence (tempêtes hivernales) dans la mobilité des formes littorales (Lee et Birkemeir, 1993). À l'inverse, une fréquence beaucoup plus faible sera adoptée (relevé annuel) lorsque l'objectif est de suivre l'évolution d'une côte sur du long terme à très long terme (Levoy, 1998). Le problème qui se pose alors est de savoir si les modifications observées relèvent bien de l'action des agents de forçage météo-marins ou si elles ne sont pas le résultat d'erreurs inhérentes à la mesure. Cette étude se propose de quantifier à partir de traitements statistiques les incertitudes liées à la mesure de terrain effectuée au théodolite (figure 1a et 1b), et auDGPS (figure 1c et 1d). Les données utilisées proviennent de suivis réalisés sur plusieurs plages du Finistère et des Côtes d'Armor effectués dans le cadre de travaux de thèse et/ou de recherches contractuelles. Une partie de ces résultats, ceux qui concernent la mesure au théodolite, a déjà fait l'objet d'une présentation dans le cadre des séminaires de notre UMR LETG - 6554 CNRS (Suanez et al., 2005). Pour cette étude, ces données ont été réactualisées en intégrant notamment le travail sur la mesure DGPS

Mean asymptotics for a Poisson-Voronoi cell on a Riemannian manifold

In this paper, we consider a Riemannian manifold $M$ and the Poisson-Voronoi tessellation generated by the union of a fixed point $x_0$ and a Poisson point process of intensity $\lambda$ on $M$. We obtain asymptotic expansions up to the second order for the means of several characteristics of the Voronoi cell associated with $x_0$, including its volume and number of vertices. In each case, the first term of the estimate is equal to the mean characteristic in the Euclidean setting while the second term may contain a particular curvature of $M$ at $x_0$: the scalar curvature in the case of the mean number of vertices, the Ricci curvature in the case of the density of vertices and the sectional curvatures in the cases of the volume and number of vertices of a section of the Voronoi cell. Several explicit formulas are also derived in the particular case of constant curvature. The key tool for proving these results is a new change of variables formula of Blaschke-Petkantschin type in the Riemannian setting. Finally, a probabilistic proof of the Gauss-Bonnet Theorem is deduced from the asymptotic estimate of the total number of vertices of the tessellation in dimension two.Comment: 44 page