The Impact of Health Status and Out-of-Pocket Medical Expenditures on Annuity Valuation

This paper describes how differences in health status at retirement can influence the decision to purchase a life annuity. We extend previous research on annuitization decisions by incorporating the effect of health differentials via differences in survival throughout the latter portion of life. Next, we consider how precautionary savings motivated by uncertain out-of-pocket medical expenses influence annuitization decisions. Our results show that annuities become less attractive to people facing uncertain medical expenses. While full annuitization would still be optimal if annuity markets were truly complete and both life- and health-contingent, lacking this, annuity equivalent wealth values are much lower for those in poor health, as compared to persons in good health.

The number of centenarians in Brazil: Indirect estimates based on death certificates

The Brazilian population is rapidly aging. As a result, the number of centenarians has grown steadily, about 77 per cent between 1991 and 2000. Although expected, the increasing number of centenarians may be exaggerated by data quality issues. We compare the recorded centenarian population in the 1991 census with indirect estimates based on the extinct generation method. We find three times more people in the census than according to the indirect estimates. Uncertainty about the true size of old-age populations has important implications in data-deficient countries, particularly in the estimation of adult mortality.age misreporting, Brazil, centenarians, longevity, mortality

The Impact of Health Status and Out-of-Pocket Medical Expenditures on Annuity Valuation

This article describes how differences in health status at retirement can influence the decision to purchase a life annuity. We extend previous research on annuitization decisions by incorporating the effect of health differentials via differences in survival throughout the latter portion of life. Next, we consider how precautionary savings motivated by uncertain out-of-pocket medical expenses influence annuitization decisions. Our results show that annuities become less attractive to people facing uncertain medical expenses. While full annuitization would still be optimal if annuity markets were truly complete and both life- and health-contingent, lacking this, annuity equivalent wealth values are much lower for those in poor health, as compared to persons in good health

Tendencias en la fecundidad de cohortes: propuesta de innovación en la forma de análisis del método P/F de Brass

Se reinterpreta la serie Pi/Fi, centrando la atención en el comportamiento de las cohortes, a fin de comparar la fecundidad de diferentes poblaciones y épocas y determinar, a partir de los datos del período, las variaciones que experimentaron las cohortes, exponiendo así el proceso de transición de la fecundidad. Se utilizan datos censales de 1970 y 1980, y se identifican y analizan las cohortes de entre 1935 y 1970 (Brasil y diez macrorregiones, sectores urbano y rural). La fecundidad de cohorte ya había estado bajando en las macrorregiones de Río de Janeiro, São Paulo y Extremo Sur desde la década de 1930. En las áreas urbanas, la caída se detectó en las de Centro-Oeste, Este, Río de Janeiro, São Paulo, Paraná y Extremo Sur. Un hallazgo importante y ausente en la literatura sobre este inicio de la caída de la fecundidad de cohorte es que se registra tanto en partes de la macrorregión de Nordeste Central —a menudo considerada de fecundidad alta y constante— como en los sectores rurales de las macrorregiones de Río de Janeiro, São Paulo y el Extremo Sur

The first 80 days of the COVID-19 pandemic in the city of Belo Horizonte : from containment to reopening.

Este artigo examina o contexto e as implica??es da pandemia por Covid-19 na cidade de Belo Horizonte (BH) nos primeiros 80 dias da doen?a. Utilizamos um recorte anal?tico descritivo para mensurar a evolu??o dos casos, o excesso de ?bitos, a taxa de transmissibilidade do v?rus e a press?o da doen?a sobre o sistema de sa?de de BH e regi?o, atrav?s da taxa de ocupa??o hospitalar nos leitos p?blicos. Al?m disso, identificamos as principais pol?ticas de conten??o adotadas pelas autoridades locais, bem como as implica??es da redu??o do distanciamento social. Nossos resultados demonstram que o Sistema ?nico de Sa?de (SUS), bem gerido, ? fundamental para o enfrentamento da pandemia e a mitiga??o de suas consequ?ncias para a popula??o. O processo de flexibiliza??o que se inicia tem imposto novos desafios que requerer?o monitoramento atento das autoridades e da sociedade.The paper examines the implications of Co vid-19 pandemic for the city of Belo Horizonte (BH), during the fi rst 80 days of the disease. We use a descriptive-analytical approach to estimate the growth of Covid-19 cases over time, the excess of deaths, the virus? rate of transmissibility, and the consequent burden on the municipal the health system, measured by the rate of occupancy of public hospital beds. Also, we identify the main containment policies adopted by local authorities, and the implications of reopen ing measures and the following reduction of social distancing. Our fi ndings reveal that a well-managed Unifi ed Health System (SUS) is paramount to effectively tackle the pan demic and its consequences for the population. The reopening process has imposed new challenges that will require close monitoring by the authorities and by the Society

Living and dying at older ages: Essays on the Hispanic mortality paradox and the annuity puzzle in the United States

The four chapters comprising this dissertation share a concern to explore issues of health and mortality at older ages in the U.S. The studies deal with three puzzles posited in the literature. First, we examine the Hispanic mortality paradox. Using mortality estimates based on Medicare records, we find that conventionally constructed Hispanic death rates are underestimated, although the results confirm the mortality advantage for Hispanics relative to non-Hispanic whites. We find that foreign-born Hispanics have lower mortality than U.S.-born Hispanics and non-Hispanic whites, and this advantage remains unaffected up to age 100. This result contradicts previous theoretical simulations for both the healthy migrant effect and the assimilation effect, which show mortality of foreign-born Hispanics converging toward that of U.S.-born Hispanic at late adult ages. The second puzzle examined is the unusually low mortality of U.S. whites at older ages, when compared to other low-mortality populations. We find surprisingly similar age patterns of mortality for several population subgroups in the U.S., suggesting that the high proportion of immigrants and people of different ethnic groups among whites does not explain the unusual age pattern of mortality for this population. In the last two essays, we shift attention to the relation of health and mortality at older ages with the “Annuity Puzzle”. We provide evidence of the existence of adverse selection in annuities. Using a multistate model, we show that the mortality of annuitants resembles that of very healthy and high educated people in the population, and that disability rates among annuitants are twice as low as in the population. Finally, we address how differences in health status at retirement influence the decision to purchase a life annuity. We propose a life cycle model in which an elderly person considers the effects of both uncertain future medical expenses and uncertain survival when choosing an optimal level of annuitization. We predict that adverse selection and precautionary motives reduce the utility value of a life annuity by almost 50 percent for people in poor health, and that full annuitization is not the optimal solution for retirees, regardless of health status. Our analysis suggests that offering higher payouts for consumers in case of medical shock can make annuities more attractive for most of the elderly