Arbeitspapier

Long-term health insurance: Theory meets evidence

To insure policyholders against contemporaneous health expenditure shocks and future reclassification risk, long-term health insurance constitutes an alternative to community-rated short-term contracts with an individual mandate. In this paper, we study the German long-term health insurance (GLTHI) from a life-cycle perspective. The GLTHI is one of the few real-world long-term health insurance markets. We first present and discuss insurer regulation, premium setting, and the main market principles of the GLTHI. Then, using unique claims panel data from 620 thousand policyholders over 7 years, we propose a new method to classify and model health transitions. Feeding the empirical inputs into our theoretical model, we assess the welfare effects of the GLTHI over policyholders' lifecycle. We find that GLTHI achieves a high level of welfare against several benchmarks. Finally, we conduct counterfactual policy simulations to illustrate the welfare consequences of integrating GLTHI into a hybrid insurance system similar to the current system in the United States.

Language
Englisch

Bibliographic citation
Series: ZEW Discussion Papers ; No. 21-094

Classification
Wirtschaft
Insurance; Insurance Companies; Actuarial Studies
Analysis of Health Care Markets
Health: Government Policy; Regulation; Public Health
Subject
long-term health insurance
individual private health insurance
reclassification risk
intertemporal incentives
ACG scores
health transitions

Event
Geistige Schöpfung
(who)
Atal, Juan Pablo
Fang, Hanming
Karlsson, Martin
Ziebarth, Nicolas R.
Event
Veröffentlichung
(who)
ZEW - Leibniz-Zentrum für Europäische Wirtschaftsforschung
(where)
Mannheim
(when)
2021

Handle
Last update
10.03.2025, 11:43 AM CET

Data provider

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Object type

  • Arbeitspapier

Associated

  • Atal, Juan Pablo
  • Fang, Hanming
  • Karlsson, Martin
  • Ziebarth, Nicolas R.
  • ZEW - Leibniz-Zentrum für Europäische Wirtschaftsforschung

Time of origin

  • 2021

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