Jang, Youngsoo (2019): Credit, Default, and Optimal Health Insurance.
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Abstract
How do defaults and bankruptcies affect optimal health insurance policy? I answer this question using a life-cycle model of health investment with the option to default on emergency room (ER) bills and financial debts. I calibrate the model for the U.S. economy and compare the optimal health insurance in the baseline economy with that in an economy with no option to default. With no option to default, the optimal health insurance is similar to the health insurance system in the baseline economy. In contrast, with the option to default, the optimal health insurance system (i) expands the eligibility of Medicaid to 22 percent of the working-age population, (ii) replaces 72 percent of employer-based health insurance with a private individual health insurance plus a progressive subsidy, and (iii) reforms the private individual health insurance market by improving coverage rates and preventing price discrimination against people with pre-existing conditions. This result implies that with the option to default, households rely on bankruptcies and defaults on ER bills as implicit health insurance. More redistributive healthcare reforms can improve welfare by reducing the dependence on this implicit health insurance and changing households’ medical spending behavior to be more preventative.
Item Type: | MPRA Paper |
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Original Title: | Credit, Default, and Optimal Health Insurance |
Language: | English |
Keywords: | Credit, Default, Bankruptcy, Optimal Health Insurance |
Subjects: | E - Macroeconomics and Monetary Economics > E2 - Consumption, Saving, Production, Investment, Labor Markets, and Informal Economy > E21 - Consumption ; Saving ; Wealth H - Public Economics > H5 - National Government Expenditures and Related Policies > H51 - Government Expenditures and Health I - Health, Education, and Welfare > I1 - Health > I13 - Health Insurance, Public and Private K - Law and Economics > K3 - Other Substantive Areas of Law > K35 - Personal Bankruptcy Law |
Item ID: | 95430 |
Depositing User: | Youngsoo Jang |
Date Deposited: | 05 Aug 2019 07:58 |
Last Modified: | 29 Sep 2019 21:20 |
References: | Ales, Laurence, Roozbeh Hosseini, and Larry E Jones, “Is There” Too Much” Inequality in Health Spending Across Income Groups?,” Technical Report, National Bureau of Economic Research 2012. Arellano, Cristina, “Default risk and income fluctuations in emerging economies,” The American Economic Review, 2008, pp. 690–712. Athreya, Kartik B, “Default, insurance, and debt over the life-cycle,” Journal of Monetary Economics, 2008, 55 (4), 752–774. Attanasio, Orazio, Sagiri Kitao, and Giovanni L Violante, “Financing Medicare: A general equilibrium analysis,” in “Demography and the Economy,” University of Chicago Press, 2010, pp. 333–366. Bell, Felicitie C and Michael L Miller, “Life Tables for the United States Social Security Area,” 2005. Carroll, Christopher D, “The method of endogenous gridpoints for solving dynamic stochastic optimization problems,” Economics letters, 2006, 91 (3), 312–320. Chatterjee, Satyajit, Dean Corbae, Makoto Nakajima, and Jos´e-V´ıctor R´ıos-Rull, “A Quantitative Theory of Unsecured Consumer Credit with Risk of Default,” Econometrica, 2007, pp. 1525–1589. Clausen, Andrew and Carlo Strub, “A General and Intuitive Envelope Theorem,” 2017. Cole, Harold L, Soojin Kim, and Dirk Krueger, “Analysing the Effects of Insuring Health Risks: On the Trade-off between Short-Run Insurance Benefits versus Long-Run Incentive Costs,” The Review of Economic Studies, 2018, p. rdy017. Conesa, Juan Carlos, Sagiri Kitao, and Dirk Krueger, “Taxing capital? Not a bad idea after all!,” American Economic Review, 2009, 99 (1), 25–48. Currie, Janet and Brigitte C Madrian, “Health, health insurance and the labor market,” Handbook of labor economics, 1999, 3, 3309–3416. Deaton, Angus, “Health, inequality, and economic development,” Journal of economic literature, 2003, 41 (1), 113–158. D´ıaz-Gim´enez, Javier, Andy Glover, and Jos´e-V´ıctor ´ıos-Rull, “Facts on the distributions of earnings, income, and wealth in the United States: 2007 update,” Federal Reserve Bank of Minneapolis Quarterly Review, 2011, 34 (1), 2–31. Dobkin, Carlos, Amy Finkelstein, Raymond Kluender, and Matthew J Notowidigdo, “The economic consequences of hospital admissions,” American Economic Review, 2018, 108 (2), 308–52. Fella, Giulio, “A generalized endogenous grid method for non-smooth and non-concave problems,” Review of Economic Dynamics, 2014, 17 (2), 329–344. Feng, Zhigang and Kai Zhao, “Employment-based health insurance and aggregate labor supply,” Journal of Economic Behavior & Organization, 2018, 154, 156–174. Finkelstein, Amy, Erzo FP Luttmer, and Matthew J Notowidigdo, “What good is wealth without health? The effect of health on the marginal utility of consumption,” Journal of the European Economic Association, 2013, 11 (suppl 1), 221–258. Franks, Peter, Marthe R Gold, and Kevin Fiscella, “Sociodemographics, self-rated health, and mortality in the US,” Social science & medicine, 2003, 56 (12), 2505–2514. Galama, Titus and Arie Kapteyn, “Grossmans missing health threshold,” Journal of Health Economics, 2011, 30 (5), 1044–1056. Gouveia, Miguel and Robert P Strauss, “Effective federal individual income tax functions: An exploratory empirical analysis,” National Tax Journal, 1994, pp. 317–339. Gross, Tal and Matthew J Notowidigdo, “Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid,” Journal of Public Economics, 2011, 95 (7), 767–778. Grossman, Michael, “On the concept of health capital and the demand for health,” The journal of political economy, 1972, pp. 223–255. Grossman, Michael, “The human capital model,” Handbook of health economics, 2000, 1, 347–408. Grossman, Michael, The demand for health: a theoretical and empirical investigation, Columbia University Press, 2017. Hall, Robert E and Charles I Jones, “The Value of Life and the Rise in Health Spending,” The Quarterly Journal of Economics, 2007, 122 (1), 39–72. Hansen, Gary D, Minchung Hsu, and Junsang Lee, “Health insurance reform: The impact of a Medicare buy-in,” Journal of Economic Dynamics and Control, 2014, 45, 315–329. Hatchondo, Juan Carlos, Leonardo Martinez, and Horacio Sapriza, “Quantitative properties of sovereign default models: solution methods matter,” Review of Economic dynamics, 2010, 13(4), 919–933. Heathcote, Jonathan, Fabrizio Perri, and Giovanni L Violante, “Unequal we stand: An empirical analysis of economic inequality in the United States, 1967–2006,” Review of Economic dynamics, 2010, 13 (1), 15–51. Holmes, Julia S and Jennifer H Madans, “Health, United States, 2012; with special feature on emergency care,” 2013. Hu, Luojia, Robert Kaestner, Bhashkar Mazumder, Sarah Miller, and Ashley Wong, “The effect of the affordable care act Medicaid expansions on financial wellbeing,” Journal of Public Economics, 2018. Jang, Youngsoo and Soyoung Lee, “Generalized Endogenous Grid Method for Models with a Default Option,” Working Paper, 2018. Jeske, Karsten and Sagiri Kitao, “US tax policy and health insurance demand: Can a regressive policy improve welfare?,” Journal of Monetary Economics, 2009, 56 (2), 210–221. Jones, Melanie K, “Disability and the labour market: a review of the empirical evidence,” Journal of Economic Studies, 2008, 35 (5), 405–424. Jung, Juergen and Chung Tran, “Market inefficiency, insurance mandate and welfare: US health care reform 2010,” Review of Economic Dynamics, 2016, 20, 132–159. Kopecky, Karen A and Tatyana Koreshkova, “The impact of medical and nursing home expenses on savings,” American Economic Journal: Macroeconomics, 2014, 6 (3), 29–72. Lacson, Eduardo, Jianglin Xu, Shu-Fang Lin, Sandie Guerra Dean, J Michael Lazarus, and RaymondMHakim, “A comparison of SF-36 and SF-12 composite scores and subsequent hospitalization and mortality risks in long-term dialysis patients,” Clinical Journal of the American Society of Nephrology, 2010, 5 (2), 252–260. Livshits, Igor, James MacGee, and Michele Tertilt, “Consumer bankruptcy: A fresh start,” American Economic Review, 2007, pp. 402–418. Livshits, Igor, James MacGee, and Michele Tertilt, “Accounting for the rise in consumer bankruptcies,” American Economic Journal: Macroeconomics, 2010, 2 (2), 165–93. Mahoney, Neale, “Bankruptcy as Implicit Health Insurance,” American Economic Review, 2015, 105 (2), 710–46. Mazumder, Bhashkar and Sarah Miller, “The effects of the Massachusetts health reform on household financial distress,” American Economic Journal: Economic Policy, 2016, 8 (3), 284– 313. Miller, Sarah, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, “The ACA Medicaid Expansion in Michigan and Financial Health,” Technical Report, National Bureau of Economic Research 2018. Nakajima, Makoto and Didem T¨uzemen, “Health Care Reform or Labor Market Reform? A Quantitative Analysis of the Affordable Care Act,” 2017. Nakajima, Makoto and Jos´e-V´ıctor R´ıos-Rull, “Credit, bankruptcy, and aggregate fluctuations,” Technical Report, National Bureau of Economic Research 2014. Nardi, Mariacristina De, Eric French, and John B Jones, “Why Do the Elderly Save? The Role of Medical Expenses,” Journal of Political Economy, 2010, 118 (1), 39–75. Østhus, Tone Brit Hortemo, Valjbona Tiric Preljevic, Leiv Sandvik, Torbjørn Leivestad, In- 58 ger Hilde Nordhus, Toril Dammen, and Ingrid Os, “Mortality and health-related quality of life in prevalent dialysis patients: Comparison between 12-items and 36-items short-form health survey,” Health and quality of life outcomes, 2012, 10 (1), 1. Pashchenko, Svetlana and Ponpoje Porapakkarm, “Quantitative analysis of health insurance reform: Separating regulation from redistribution,” Review of Economic Dynamics, 2013, 16(3), 383–404. Prados, Marıa Jos´e, “Health And Earnings Inequality Over The Life Cycle: The Redistributive Potential Of Health Policies,” 2017. Rumsfeld, John S, Samantha MaWhinney, Martin McCarthy Jr, A Laurie W Shroyer, Catherine B VillaNueva, Maureen O’brien, Thomas E Moritz, William G Henderson, Frederick L Grover, Gulshan K Sethi et al., “Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery,” Jama, 1999, 281 (14), 1298–1303. Storesletten, Kjetil, Chris I Telmer, and Amir Yaron, “Cyclical dynamics in idiosyncratic labor market risk,” Journal of Political Economy, 2004, 112 (3), 695–717. Suen, Richard MH et al., “Technological advance and the growth in health care spending,” Economie DAvant Garde, Research Report, 2006, (13). Sullivan, Teresa A, ElizabethWarren, and Jay LawrenceWestbrook, The fragile middle class: Americans in debt, Yale University Press, 2001. Yogo, Motohiro, “Portfolio choice in retirement: Health risk and the demand for annuities, housing, and risky assets,” Journal of Monetary Economics, 2016, 80, 17–34. Zhao, Kai, “Social security and the rise in health spending,” Journal of Monetary Economics, 2014, 64, 21–37. Zhao, Kai, “Social insurance, private health insurance and individual welfare,” Journal of Economic Dynamics and Control, 2017, 78, 102–117. 59 |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/95430 |
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Credit, Default, and Optimal Health Insurance. (deposited 03 Aug 2019 10:36)
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