Community Rating, Entry-Age Rating and Adverse Selection in Private Health Insurance in Australia

@article{Buchmueller2008CommunityRE,
  title={Community Rating, Entry-Age Rating and Adverse Selection in Private Health Insurance in Australia},
  author={T. Buchmueller},
  journal={The Geneva Papers on Risk and Insurance - Issues and Practice},
  year={2008},
  volume={33},
  pages={588-609}
}
  • T. Buchmueller
  • Published 2008
  • Economics
  • The Geneva Papers on Risk and Insurance - Issues and Practice
The regulation of health insurance is an important and often controversial issue. Rules intended to improve access to insurance for high-risk consumers have the potential to reduce overall coverage by inducing adverse selection. This paper examines the issue of adverse selection in the context of the market for private health insurance in Australia, before and after the implementation of a major policy reform in 2000. The policy, known as Lifetime Health Cover (LHC), created a financial… Expand
The introduction of lifetime community rating in the Irish private health insurance market: Effects on coverage and plan choice.
  • C. Keegan
  • Medicine, Business
  • Social science & medicine
  • 2020
TLDR
The introduction of LCR has encouraged insurance take-up by those who may have otherwise postponed take- up to older ages contributing to a reversal in declining overall coverage trends, at least initially. Expand
Preference heterogeneity and selection in private health insurance: the case of Australia.
A basic prediction of theoretical models of insurance is that if consumers have private information about their risk of suffering a loss there will be a positive correlation between risk and theExpand
Adverse Selection in Private Health Insurance
TLDR
This paper examines the latter issue of adverse selection in Australian PHI based on recent survey data, particularly in relation to whether high-risk consumers with ageing, long-term health conditions, and other significant health-risk factors are more likely to subscribe to PHI. Expand
Advantageous Selection in Private Health Insurance: The Case of Australia
A basic prediction of theoretical models of insurance is that if consumers have private information about their risk of suffering a loss there will be a positive correlation between risk and theExpand
Why ‘Optimal’ Payment for Healthcare Providers Can Never be Optimal Under Community Rating
TLDR
Consumer heterogeneity spills over into relationships with providers, such that a uniform contract with providers also cannot be optimal, and experimental and market evidence for a high degree of heterogeneity is presented. Expand
1 REMEDIES FOR SICK INSURANCE
This expository paper describes the factors that contribute to failure of health insurance markets, and the regulatory mechanisms that have been and can be used to combat these failures. StandardizedExpand
The effect of income-based mandates on the demand for private hospital insurance and its dynamics.
TLDR
The results indicate that being subject to the MLS penalty in a given year increases the probability of purchasing private hospital insurance by between 2 to 3 percent in that year, and this probability grows further over the following years, reaching 13 percent after a decade. Expand
The Effect of Income-Based Mandates on the Demand for Private Hospital Insurance and its Dynamics
We examine the effect of an income-based mandate on the demand for private hospital insurance and its dynamics in Australia. The mandate, known as the Medicare Levy Surcharge (MLS), is a levy onExpand
Remedies for Sick Insurance
This expository paper describes the factors that contribute to failure of health insurance markets, and the regulatory mechanisms that have been and can be used to combat these failures. StandardizedExpand
Measuring the effects of reducing subsidies for private insurance on public expenditure for health care.
  • T. Cheng
  • Economics, Medicine
  • Journal of health economics
  • 2014
TLDR
The simulation projections show that reducing premium subsidies is expected to generate net cost savings, and this arises because the cost savings achieved from reducing subsidies are larger than the potential increase in public expenditure on hospital care. Expand
...
1
2
3
...

References

SHOWING 1-10 OF 32 REFERENCES
Lifetime Subsidies in Australian Private Health Insurance Markets with Community Rating
This paper considers the problem of inducing low-risk individuals of all ages to buy private health insurance in Australia. Our proposed subsidy scheme improves upon the age-based penalty schemeExpand
Lifetime Cover in Private Insurance Markets
TLDR
This paper analyze Australia’s Lifetime Cover in the context of a modified version of the Rothschild-Stiglitz insurance model, which allows empirically-based probabilities to increase by age for low-risk types and predicts that Lifetime Cover will not arrest adverse selection. Expand
Adverse Selection and the Decline in Private Health Insurance Coverage in Australia: 1989-95
The decline in private health insurance coverage over the period 1989–95 is analysed using the ABS National Health Surveys. Individuals’ health status and health risk behaviours are found to beExpand
A Critique of the Private Health Insurance Regulations
The private health insurance sector is one of the most regulated sectors in Australia. The Private Health Insurance Incentives Scheme, along with community rating, is intended to make privateExpand
Premium Variation in the Individual Health Insurance Market
  • B. Herring, M. Pauly
  • Business, Medicine
  • International Journal of Health Care Finance and Economics
  • 2004
TLDR
It is found that premiums vary less than proportionately with expected expense and vary only with certain risk characteristics for persons insured by HMOs and in markets dominated by managed care insurers. Expand
Policy change and private health insurance: did the cheapest policy do the trick?
  • J. Butler
  • Medicine, Economics
  • Australian health review : a publication of the Australian Hospital Association
  • 2002
TLDR
It is argued that the membership uptake that has occurred recently is largely attributable to the introduction of lifetime community rating which goes some way towards addressing the adverse selection associated with the previous community rating regulations. Expand
The effect of health on acute care supplemental insurance ownership: an empirical analysis.
TLDR
The analysis shows that while the reduced-form health effect on ownership is negligible, the structural effects are sizeable and indicate that sicker individuals are more likely to apply, but are also morelikely to be rejected in the Israeli market for acute care supplemental health insurance. Expand
How effective is “lifetime health cover” in raising private health insurance coverage in Australia? An assessment using regression discontinuity
The Australian government introduced three major private health insurance policy initiatives in recent years. These are, in chronological order, (i) the Private Health Insurance Incentives SchemeExpand
Adverse selection and the purchase of Medigap insurance by the elderly.
  • S. Ettner
  • Business, Medicine
  • Journal of health economics
  • 1997
TLDR
Two part models of Medicare utilization and expenditures showed that beneficiaries with individually purchased policies had higher total, part B and physician expenditures than those with employer-provided policies, even after controlling for observable differences, suggesting adverse selection. Expand
How has small group market reform affected employee health insurance coverage
Abstract In the early 1990s, over 40 states passed legislation designed to limit a number of exclusionary practices by insurers in the small group market in order to improve the availability andExpand
...
1
2
3
4
...