Income and the Demand for Complementary Health Insurance in France

This paper examines the demand for complementary health insurance (CHI) in the non-group market in France and the reasons why the near poor seem price insensitive. First we develop a theoretical model based on a simple tradeoff between two goods: CHI and a composite good reflecting all other consumptions. Then we estimate a model of CHI consumption and empirically test the impact of potential determinants of demand for coverage: risk aversion, asymmetrical information, non-expected utility, the demand for quality and health, and supply-side factors such as price discrimination. We interpret our empirical findings in terms of crossed price and income elasticity of the demand for CHI. Last, we use these estimates of elasticity to simulate the effect of various levels of price subsidies on the demand for CHI among those with incomes around the poverty level in France. We find that the main motivation for purchasing CHI in France is protection against the financial risk associated with co-payments in the public health insurance scheme. We also observe a strong income effect suggesting that affordability might be an important determinant. Our simulations indicate that no policy of price subsidy can significantly increase the take-up of CHI among the near poor; any increase in the level of subsidy generates a windfall benefit for richer households.Demand for health insurance, Uninsured, Premium subsidies

Coûts de l’autoprotection et équilibre d’un marché de l’assurance concurrentiel

This paper considers a competitive insurance market under moral hazard and adverse selection, in which both the agent’s preventive effort and self protection costs are unobservable by the insurance companies. We show that the agent provides the same level of self-protection than without adverse selection. The agent who has a higher marginal cost is proposed his moral hazard contract whereas adverse selection may make the lower marginal cost agent’s coverage to decrease. Finally, equilibrium may not exist. Nous considérons un marché concurrentiel de l’assurance en présence d’aléa moral dans lequel le niveau du coût de l’autoprotection de l’assuré est son information privée. Nous caractérisons alors l’équilibre en contrats du marché en supposant qu’il existe deux types d’agents : un type à faible coût marginal de l’effort et un autre dont le coût marginal est élevé. D’une part, nous montrons que le niveau de l’autoprotection de l’agent à l’équilibre est le même que dans la situation d’aléa moral pur. D’autre part, nous montrons qu’à l’équilibre les agents dont le coût marginal de l’effort est élevé obtiennent le même contrat que dans la situation d’aléa moral pur alors que l’autre type d’agents peut obtenir une couverture d’assurance plus faible. Enfin, l’existence de l’équilibre n’est pas toujours garantie.

Les franchises ont-elles modifié les comportements d’achats de médicaments : une étude à partir de données déclaratives d’ESPS 2008.

Médicaments;

Coûts de l’autoprotection et équilibre d’un marché de l’assurance concurrentiel

Nous considérons un marché concurrentiel de l’assurance en présence d’aléa moral dans lequel le niveau du coût de l’autoprotection de l’assuré est son information privée. Nous caractérisons alors l’équilibre en contrats du marché en supposant qu’il existe deux types d’agents : un type à faible coût marginal de l’effort et un autre dont le coût marginal est élevé. D’une part, nous montrons que le niveau de l’autoprotection de l’agent à l’équilibre est le même que dans la situation d’aléa moral pur. D’autre part, nous montrons qu’à l’équilibre les agents dont le coût marginal de l’effort est élevé obtiennent le même contrat que dans la situation d’aléa moral pur alors que l’autre type d’agents peut obtenir une couverture d’assurance plus faible. Enfin, l’existence de l’équilibre n’est pas toujours garantie.This paper considers a competitive insurance market under moral hazard and adverse selection, in which both the agent’s preventive effort and self protection costs are unobservable by the insurance companies. We show that the agent provides the same level of self-protection than without adverse selection. The agent who has a higher marginal cost is proposed his moral hazard contract whereas adverse selection may make the lower marginal cost agent’s coverage to decrease. Finally, equilibrium may not exist

Prévention des risques en présence d’asymétries d’information : quelques résultats théoriques

La prévention est une dimension essentielle de la gestion des risques. L’assurance permet de couvrir les risques mais ne permet pas toujours de mettre en oeuvre les niveaux de prévention optimaux à cause des asymétries d’information entre assureurs et assurés. Les incitations à la prévention des risques de responsabilité civile sont, elles aussi, touchées par les problèmes d’information. De plus, pour gérer cette catégorie de risques, une attention particulière doit être portée à la capacité financière des responsables à supporter les externalités qu’ils génèrent ainsi qu’aux garanties financières qui peuvent être offertes aux agents pouvant rencontrer une limite de solvabilité.Prevention is an essential aspect of risk management. Insurance makes it possible to cover risks, but does not always allow implementing the optimal level of prevention because of asymmetric information between insurers and policyholders. Prevention of liability risks is also affected by asymmetric information but a key point when considering this kind of risk is the potential insolvency of the injurer party. A particular attention may be devoted to the financial ability of injurers and financial guarantees that can be offered to those who can be bankrupted by their liability

Environmental risks, the judgment-proof problem and financial responsibility

Alternative risk transfer, Environmental risk, Financial responsibility, Judgment-proof problem, Moral hazard, D21, D82, K13, K32,

Aléa moral et selection adverse sur le marché de l’assurance

This paper considers a competitive insurance market under moral hazard and adverseselection, in which both the agent’s preventive effort and self protection costs are unobservableby the insurance companies. We show that the results of the adverse selection model(Rothschild and Stiglitz (1976)) can apply to our context even if it involves moral hazard.The agents with a higher marginal cost opt for a lower self protection level, so their accidentprobability is the highest. They are proposed their moral hazard contract. Adverse selectionmakes the others agents’ coverage to decrease, increasing likewise their preventive action.We compare in a second time our results under moral hazard and adverse selection to theequilibrium in a market where prevention could be observed. Under reasonable assumptions,the conclusions of Rothschild and Stiglitz (1976) seem very robust.

Prevention in insurance markets

This paper considers a competitive insurance market under moral hazard and adverse selection, in which preventive efforts and self-protection costs are unobservable by insurance companies. Under reasonable assumptions, the conclusions of Rothschild and Stiglitz (1976) are preserved in our context even if it involves moral hazard. The riskier agents in equilibrium, who would also be the riskier agents under perfect information, receive their moral hazard contract. For other agents, adverse selection reduces coverage, increasing likewise their preventive effort with respect to the hidden-action situation.