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Review of Economic Studies Vol. 86 No. 3 2019

Analysing the Effects of Insuring Health Risks: On the Trade-off between Short-Run Insurance Benefits versus Long-Run Incentive Costs

Harold L. Cole1; Soojin Kim2; Dirk Krueger3

1 University of Pennsylvania and NBER · 2 Purdue University · 3 University of Pennsylvania, CEPR, CFS, NBER and Netspar

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.

DOI
10.1093/restud/rdy017
Volume
86
Issue
3
Pages
1123-1169
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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