Analysing the Effects of Insuring Health Risks: On the Trade-off between Short-Run Insurance Benefits versus Long-Run Incentive Costs
中文摘要
本文定量评估了提供健康相关社会保险与通过高成本投资维持良好健康的激励之间的权衡。为此，我们构建并估计了一个健康投资与健康保险的动态模型，其中横截面健康分布内生演化，并受到劳动市场与健康保险政策的塑造。劳动市场中的禁止工资歧视法限制了工资在多大程度上可以取决于工人的健康状况，而禁止既往病症法则禁止对健康状况较差的个人收取更高的保险费。在该模型中，由这些政策引致的、针对健康不佳的更好保险的静态收益，与其对家庭过上健康生活努力产生的负面动态激励效应之间存在权衡。在我们的定量分析中，我们发现为80%的劳动市场相关收入风险投保是最优的（如果同时存在禁止既往病症法，则为70%）。然而，提供全额保险是强烈次优的，因为在较高的消费保险水平下，对健康努力的负面动态激励效应进而对长期人口健康分布的影响，将开始主导短期消费保险收益。
Abstract
This article quantitatively evaluates the trade-off between the provision of health-related social insurance and the incentives to maintain good health through costly investments. To do so, we construct and estimate a dynamic model of health investments and health insurance in which the cross-sectional health distribution evolves endogenously and is shaped by labour market and health insurance policies. A no wage discrimination law in the labour market limits the extent to which wages can depend on the health status of a worker, and a no prior conditions law outlaws higher insurance premia for individuals with worse health status. In the model, the static gains from better insurance against poor health induced by these policies are traded off against their adverse dynamic incentive effects on household efforts to lead a healthy life. In our quantitative analysis, we find that it is optimal to insure 80% of labour market-related income risk (70% if a no prior conditions law is also present). Providing full insurance is strongly suboptimal, however, since at high levels of consumption insurance, the negative dynamic incentive effects on health effort and thus the population health distribution in the long run start to dominate the short-run consumption insurance gains.