Pashchenko, Svetlana and Porapakkarm, Ponpoje (2010): Quantitative Analysis of Health Insurance Reform: Separating Community Rating from Income Redistribution.
Preview |
PDF
MPRA_paper_26158.pdf Download (415kB) | Preview |
Abstract
Two key components of the upcoming health reform are a reorganization of the individual health insurance market and an increase in income redistribution in the economy. Which component contributes more to the welfare outcome of the reform? We address this question by constructing a general equilibrium life cycle model that incorporates both medical expenses and labor income risks. We replicate the key features of the current health insurance system in the U.S. and calibrate the model using the Medical Expenditures Panel Survey dataset. We find that the reform decreases the number of uninsured more than four times. It also brings significant welfare gains equivalent to almost one percent of the annual consumption. However, these welfare gains mostly come from the redistributive measures embedded in the reform. If the reform only reorganizes the individual market, introduces individual mandates but does not include any income-based transfers, the welfare gains are much smaller. This result is mostly driven by the fact that most uninsured people have low income. High burdens of health insurance premiums for this group are relieved disproportionately more by income-based measures than by the new rules in the individual market.
Item Type: | MPRA Paper |
---|---|
Original Title: | Quantitative Analysis of Health Insurance Reform: Separating Community Rating from Income Redistribution |
Language: | English |
Keywords: | health insurance, health reform, risk sharing, general equilibrium |
Subjects: | E - Macroeconomics and Monetary Economics > E6 - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook > E65 - Studies of Particular Policy Episodes D - Microeconomics > D9 - Intertemporal Choice > D91 - Intertemporal Household Choice ; Life Cycle Models and Saving D - Microeconomics > D5 - General Equilibrium and Disequilibrium > D52 - Incomplete Markets E - Macroeconomics and Monetary Economics > E2 - Consumption, Saving, Production, Investment, Labor Markets, and Informal Economy > E21 - Consumption ; Saving ; Wealth I - Health, Education, and Welfare > I1 - Health > I10 - General |
Item ID: | 26158 |
Depositing User: | Svetlana Pashchenko |
Date Deposited: | 27 Oct 2010 14:31 |
Last Modified: | 27 Sep 2019 13:16 |
References: | [1] Aiyagari, S. R. (1994); Uninsured Idiosyncratic Risk and Aggregate Saving, Quarterly Journal of Economics, 109(3), 659-684. [2] Attanasio, Orazio, Sagiri Kitao and Gianluca Violante (2008); Financing Medicare: A General Equilibrium Analysis, in J.B. Shoven, ed., Topics in Demography and the Economy. [3] Bewley T. F. (1986); Stationary Monetary Equilibrium with a Continuum of In- dependently Fluctuating Consumers, In W. hildenbrand and A. Mas-Colell (Eds.), Contributions to Mathematical Economics in Honor of Gerald Debreu, Amsterdam: North-Holland. [4] Brugemann, BjÄorn and Iourii Manovskii (2010); Fragility: A Quantitative Analysis of the US Health Insurance System, manuscript, Yale University [5] Buchmueller, Thomas and Alan Monheit (2009); Employer-Sponsored Health Insur- ance and the Promise of Health Insurance Reform, NBER Working Paper No.14839 [6] Cochrane, John (1995); Time-consistent Health Insurance, The Journal of Political Economy, Vol.103, No.3. [7] Cochrane, John (2009); Health-Status Insurance. How Market Can Provide Health Security, The CATO Institute Policy Analysis, No.633. [8] Conesa, Juan Carlos, and Dirk Krueger (2006); On the Optimal Progressivity of the Income Tax Code, Journal of Monetary Economics, 53(7) [9] Cutler, David and Jonathan Gruber (1996); Does Public Insurance Crowd Out Pri- vate Insurance?, Quarterly Journal of Economics, 1996 [10] Deaton, Angus, and Christina Paxson (1994); Intertemporal Choice and Inequality, Journal of Political Economy, Vol. 102 [11] De Nardi, Mariacristina, Eric French and John Jones (2010); Why Do the Elderly Save?, Journal of Political Economy, 118(1) [12] Feng, Zhigang (2009); Macroeconomic Consequences of Alternative Reforms to the Health Insurance System in the U.S., Mimeo, University of Zurich [13] Floden, Martin (2008); A Note on the Accuracy of Markov-chain Approximations to Highly Persistent AR(1) Processes, Economic Letters, No.99 [14] Gruber, Jonathan (1998); Health Insurance and the Labor Market, NBER Working Paper No.6762. [15] Gruber, Jonathan and Robin McKnight (2003); Why Did Employee Health Insurance Contributions Rise?, Journal of Health Economics, 22, 2003. [16] Guvenen, Fatih (2006); Learning Your Earning: Are Labor Income Shocks Really Very Persistent?, American Economic Review, Vol. 97, No. 3 [17] Herring, Bradley and Mark Pauly (2003); Incentive-Compatible Guaranteed Renew- able Health Insurance, NBER Working Paper No.9888. [18] Hsu, Minchung, and Junsang Lee (2009); The Provision of Public Health Insurance: Impacts on Private Insurance, Portfolio Choices and Welfare, mimeo, Australian National University [19] Hubbard, Glenn, Jonathan Skinner and Stephen Zeldes (1994); The Importance of Precautionary Motives in Explaining Individual and Aggregate Saving, Carnegie- Rochester Conference Series on Public Policy, Volume 40 [20] Hugget R (1993); The Risk-free Rate in Heterogeneous-Agent Incomplete-insurance Economies, Journal of Economic Dynamics and Control, No.17:953-969 [21] Imrohoroglu (1989); Cost of Business Cycles with Individibilities and Liquidity Con- straints, Journal of Political Econoomy, 97(6), 1364-83 [22] Imrohoroglu (1992); Welfare Cost of In°ation Under Imperfect Insurance, Journal of Economic dynamic and Control, 16(1), 953-969. [23] Jeske, Karsten, and Sagiri Kiao (2007) ; U.S. Tax Policy and Health Insurance De- mand: Can a Regressive Policy Improve Welfare?, Journal of Monetary Economics, 56(2), 210-221. [24] Jung, Juergen and Chung Tran (2009), Health Care Financing Over the Life Cycle, Universal Medical Vouchers and Welfare, Mimeo, University of New South Wales [25] Kaiser Family Foundation (2008), Tax Subsidies for Health Insurance: An Issue Brief, available at http://www.k®.org/insurance/upload/7779.pdf. [26] Kahn, James, Richard Kronick, Mary Kreger, and David Gans (2005), The Cost of Health Insurance Administration in Califarnia: estimates for insurers, physicians, and hospitals, Health A®airs No.24 [27] Kashiwase, Kenichiro (2009), Macroeconomic Implications of Health Policy in the United States, mimeo, University of Michigan [28] Kennickel, Arthur (2003), A Rolling Tide: Changes in the Distribution of Wealth in the U.S., 1989-2001, mimeo, Federal Reserve Board [29] Kopecky, Karen and Tatyana Koreshkova (2009), The Impact of Medical and Nursing Home Expenses and Social Insurance Policies on Savings and Inequality, mimeo, University of Western Ontario [30] Lemieux, Je® (2005), Perspective: Administrative Costs of Private Health Insurance Plans, Center for Policy and Research, America's Health Insurance Plans [31] Palumbo, Michael (1999); Uncertain Medical Expenses and Precautionary Saving in the End of Life Cycle, Review of Economic Studies, 66(2) [32] Pauly, Mark (1970); The Welfare Economics of Community Rating, The Journal of Risk and Insurance, Vol.37, No.3 [33] Pauly, Mark (2010); Health Reform Without Side E®ects, Hoover Institution Press Publication No. 580 [34] Pauly, M. V., H. Kunreuther, and R. Hirth (1995); Guaranteed Renewability in Insurance, Journal of Risk and Uncertainty, 10, 143{156. [35] Selden, Thomas and Didem Bernard (2004); Tax Incidence and Net Bene¯ts in the Market for Employment-Related Health Insurance: Sensitivity of Estimates to the Incidence of Employer Costs, International Journal of Health Care Finance and Economics, 4(2), 167-92. [36] Sholz, John Karl, Ananth Seshadri and Surachai Khitatrakun (2006); Are Americans Saving Optimally for Retirement?, Journal of Political Economy, 114(4) [37] Storesletten, Kjetil, Chris Telmer, and Amir Yaron (2004); Consumption and Risk Sharing Over the Life Cycle Journal of Monetary Economics, Volume 51, Issue 3 [38] Tauchen, George and Robert Hussey (1991); Quadrature-Based Methods for Obtain- ing Approximate Solutions to Nonlinear Asset Pricing Models, Econometrica, 59 [39] Young, Eric (2010); Solving the Incomplete Markets Model with Aggregate Uncer- tainty Using the Krusell-Smith Algorithm and Non-Stochastic Simulations, Journal of Economic Dynamics and Control, 34 |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/26158 |