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Business and Economics > Insurance

You are looking at 1 - 10 of 22 items for :

  • Type: Journal Issue x
  • Health, Education, and Welfare x
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Cover IMF Working Papers
Intergenerational Transmission of Education in a Developing Country: Evidence from A Mass Education Program in Vietnam
Trung Hoang
and
Ha Nguyen
We study the long-run and multi-generational effects of a mass education program in Vietnam during the First Indochina War (1946-1954). Difference-in-difference estimations indicate that the children of mothers exposed to the education program had an average of 0.9 more years of education. We argue that the impact is via mother’s education. An additional year of maternal education increases children’s education by up to 0.65 years, a stronger effect than those found in the existing literature. Better household lifestyles and a stronger focus on education are possible transmission pathways.
Keywords:
mass education; human capital transmission; mother education; Vietnam; education program; ha Nguyen; household lifestyle; intergenerational transmission; Labor markets; Income; Women; Insurance; Global
Cover IMF Working Papers
U.S. Healthcare: A Story of Rising Market Power, Barriers to Entry, and Supply Constraints
Ms. Li Lin
and
Mr. Mico Mrkaic
Healthcare in the United States is the most expensive in the world, with real per capita spending growth averaging 4 percent since 1980. This paper examines the role of market power of U.S. healthcare providers and pharmaceutical companies. It finds that markups (the ability to charge prices above marginal costs) for publicly listed firms in the U.S. healthcare sector have almost doubled since the early 1980s and that they explain up to a quarter of average annual real per capita healthcare spending growth. The paper also finds evidence that the Affordable Care Act and Medicaid expansion were successful in raising coverage and expanding care, but may have had the undesirable side-effect of leading to labor cost increases: Hourly wages for healthcare practitioners are estimated to have increased by 2 to 3 percent more in Medicaid expansion states over a five-year period, which could be an indication that the supply of medical services is relatively inelastic, even over a long time horizon, to the boost to demand created by the Medicaid expansion. These findings suggest that promoting more competition in healthcare markets and reducing barriers to entry can help contain healthcare costs.
Keywords:
Medicaid expansion; sector markup; healthcare cost; healthcare in the United States; healthcare provider; Wages; Employment; Insurance companies; Insurance; Labor costs; Global
Cover IMF Working Papers
Unintended Effects From the Expansion of the Non-Contributory Health System in Peru
Mr. Jose L. Torres
Over the last two decades, the Peruvian government has made great efforts to improve access to health care by significantly augmenting the coverage of the non-contributory public health care system Seguro Integral de Salud (SIS). This expansion has a positive impact on welfare and public health indicators, as it limits the risk of catastrophic health-related costs for previously uninsured individuals and allows for the appropriate treatment of illnesses. However, it also entails some unintended consequences for informality, tax revenues, and GDP, since a few formal agents are paying for a service that the majority of (informal) agents receive for free. In this paper, we use a general equilibrium model calibrated for Peru to simulate the expansion of SIS to quantify the unintended effects. We find that overall welfare increases, but informality rises by 2.7 percent, while tax revenues and output decrease by roughly 0.1 percent. Given the extent of the expansion in eligibility, the economic relevance of these results seems negligible. However, this occurs because the expansion of coverage was mostly funded by reducing the spending per-insured person. In fact, we find larger costs if public spending is increased to improve the quality of service given universal coverage.
Keywords:
care system Seguro Integral de Salud; IMF working paper Western Hemisphere department; unintended effect; health shock; health risk; avg. health spending; non-contributory health system SIS; Self-employment; Health care; Health care spending; Insurance; South America; Caribbean
Cover IMF Working Papers
The Impact of Community Based Health Insurance Schemes on Out-of-Pocket Healthcare Spending: Evidence from Rwanda
Andinet Woldemichael
,
Daniel Gurara
, and
Abebe Shimeles
Achieving universal health coverage, including financial risk protection and access to quality essential health-care services, is one of the main Sustainable Development Goals. In low-income countries, innovative and affordable health financing systems are key to realize these goals. This paper assesses the impacts of Community-Based Health Insurance Scheme in Rwanda on health-related financial risks using a nationally representative household survey data collected over a ten-year period. We find that the scheme significantly reduce annual per capita out-of-pocket spending by about 3,600 Rwandan Franc (about US$12) or about 83 percent of average per capita healthcare expenditure compared to the baseline level in 2000.The impacts however favor the rich as compared to the poor. The program also reduces the incidence of catastrophic healthcare spending significantly.
Keywords:
WP; normal distribution; sensitivity analysis; Healthcare spending; health insurance; low-income; Rwanda; CBHI scheme; CBHI enrollment; CBHI member household; CBHI effect; CBHI membership rate; Insurance; Income; Consumption; Africa
Cover IMF Working Papers
Barriers to Household Risk Management: Evidence from India
Robert M. Townsend
,
Ms. Shawn Cole
,
Mr. Jeremy Tobacman
,
Mr. Xavier Gine
,
Mr. James Ian Vickery
, and
Petia Topalova
Why do many households remain exposed to large exogenous sources of non-systematic income risk? We use a series of randomized field experiments in rural India to test the importance of price and non-price factors in the adoption of an innovative rainfall insurance product. Demand is significantly price sensitive, but widespread take-up would not be achieved even if the product offered a payout ratio comparable to U.S. insurance contracts. We present evidence suggesting that lack of trust, liquidity constraints and limited salience are significant non-price frictions that constrain demand. We suggest contract design improvements to mitigate these frictions.
Keywords:
WP; Gujarat video experiment; product endorsement; financial product; insurance demand; expected return; Gujarat video treatment; payout slope; product diffusion; Insurance; Household Finance; Trust; Liquidity Constraints; Economic Development; Andhra Pradesh sample; Insurance companies; Consumption; Liquidity; Africa
Cover The Economics of Public Health Care Reform in Advanced and Emerging Economies
The Economics of Public Health Care Reform in Advanced and Emerging Economies
Mr. David Coady
,
Mr. Benedict J. Clements
, and
Mr. Sanjeev Gupta

Abstract

Using cross-country analysis and case studies, this book provides new insights and potential policy responses for the key fiscal policy challenges that both advanced and emerging economies will be facing.

Keywords:
BOOK; spending; health system; health outcome; cost; EAP country; health spending; OECD health data; Health care spending; Health care; Insurance; Global; Asia and Pacific; Europe; East Asia; Africa; system efficiency; Caribbean
Cover IMF Working Papers
The Impact of Longevity Improvements on U.S. Corporate Defined Benefit Pension Plans
Mr. John Kiff
,
Michael Kisser
,
Mauricio Soto
, and
Mr. S. E Oppers
This paper provides the first empirical assessment of the impact of life expectancy assumptions on the liabilities of private U.S. defined benefit (DB) pension plans. Using detailed actuarial and financial information provided by the U.S. Department of Labor, we construct a longevity variable for each pension plan and then measure the impact of varying life expectancy assumptions across plans and over time on pension plan liabilities. The results indicate that each additional year of life expectancy increases pension liabilities by about 3 to 4 percent. This effect is not only statistically highly significant but also economically: each year of additional life expectancy would increase private U.S. DB pension plan liabilities by as much as $84 billion.
Keywords:
WP; mortality table; mortality rate; life expectancy; group Annuity mortality table; Pension Plans; Longevity Risk; Mortality; pension liability; Individual Annuity mortality table; freedom pension plan sponsor; DB pension plan provider; benefit pension plans; Pensions; Pension spending; Aging; Insurance; Global
Cover Technical Notes and Manuals
Health Care Spending Issues in Advanced Economies
Ms. Eva Jenkner
and
Adam Leive
This technical note analyzes the health care spending issues in advanced economies. Both public and total health spending have increased substantially in advanced countries. Total health spending increased by more than 6 percentage points of GDP in the Organization for Economic Cooperation and Development countries between 1970 and 2007. This note examines the recent trends in health care spending in advanced countries. It discusses the main challenges for advanced countries over the medium term. Policy options for containing health care costs are also described.
Keywords:
TNM; patient; spending; cost; physician; health care spending; health reforms; cost containment; advanced economies; provider payment method; cost sharing; health status; Medicaid patient; OECD health datum; physician payment; expenditure growth; health sector; prescription drug spending; Health care; Insurance; Africa; Caribbean
Cover IMF Working Papers
Economic Transition and Health Care Reform: The Experience of Europe and Central Asia
Adam Leive
This paper exploits the staggered adoption of major concurrent health reforms in countries in Europe and Central Asia after 1990 to estimate their impact on public health expenditure, utilization, and avoidable deaths. While the health systems all derived from the same paradigm under central planning, they have since introduced changes to policies regarding cost-sharing, provider payment, financing, and the rationalization of hospital infrastructure. Social health insurance is predicted to increase this share, although the leads of both social health insurance and primary care fee-for-service suggest endogeneity may be an issue with the outpatient share regressions. Provider payment reforms produce the largest impact on spending, with fee-for-service increasing spending and patient-based payment reducing it. The impact on avoidable deaths is generally negligible, but there is some evidence of improvements due to fee-for-service. Considering the corresponding relative reduction in inpatient admissions and the incentives fee-for-service provides to deliver additional services, perhaps there is an overprovision of services in the primary care setting and an underutilization of more specialized hospital services.
Keywords:
WP; hospital PBP; hospital fee-for-service; payment reform; hospital payment variable; hospital payment coefficient
Cover IMF Working Papers
Life Expectancy and Income Convergence in the World: A Dynamic General Equilibrium Analysis
Mr. Kenichi Ueda
There is world-wide convergence in life expectancy, despite little convergence in GDP per capita. If one values longer life much more than material happiness, the world living standards may this have already converged substantially. This paper introduces the concept of the dynastic general equilibrium value of life to measure welfare gains from the increase in life expectancy. A calibration study finds sizable welfare gains, but these gains hardly mitigate the large inequality among countries. A conventional GDP-based measure remains a good approximation for (non) convergence in world living standards, even when adjusted for changes in life expectancy.
Keywords:
WP; life expectancy; physical capital; depreciation rate; law of motion