Adverse and Advantageous Selection in the Laboratory

We study two-player games where one-sided asymmetric information can lead to either adverse or advantageous selection. We contrast behavior in these games with settings where both players are uninformed. We find stark differences, suggesting that subjects do account for endogenous selection effects. Removing strategic uncertainty increases the fraction of subjects who account for selection. Subjects respond more to adverse than advantageous selection. Using additional treatments where we vary payoff feedback, we connect this difference to learning. We also observe a significant fraction of subjects who appear to understand selection effects but do not apply that knowledge. (JEL C92, D82, D91)

Risk selection into supplemental private health insurance in China

Background Information on risk selection is important for the regulation and development of supplemental private health insurance (PHI). The research on risk selection into supplemental PHI has been documented in several developed countries where the regulation of the PHI markets was relatively mature. However, evidence on this important aspect of the supplemental PHI market in China is still absent in the literature. The private insurers in China were not prohibited from discrimination against pre-existing conditions and did not guarantee ongoing enrolment. Therefore, the direction and degree of risk selection could not be inferred using the evidence from the other countries. To provide evidence on risk selection into supplemental PHI in China, we conducted a cross-sectional analysis using data from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). Results Using probit models, we found that individuals having better self-reported general health were more likely to enrol in PHI in China, suggesting advantageous selection. This result was confirmed by an alternative analysis using an instrumental variable. We also adjusted the realized occurrence of hospitalization by excluding potential moral hazard effect and showed that the adjusted hospitalization risk was negatively associated with PHI enrolment, which also indicated advantageous selection. Conclusions The findings suggested potential over-insurance of healthier individuals or under-insurance of less healthy individuals. The regulation of the PHI market in China should aim to address the inefficiency. The current study could also contribute to the information base for policymakers in countries where the PHI markets similarly lack strong regulation.

Calculation of cost-optimal combination of building materials and technical systems for nZEB single-family house using global cost calculation method

As a rule, during the design stage of a single-family house, only initial costs are taken into account and optimised. Long-term financial calculations are usually not even made. At the same time, total costs to design, build and operate the building show a real difference in expenses while living in this house. In the case of nearly zero energy buildings (nZEBs), this global cost approach becomes especially useful because of the strict requirements of heating and primary energy, as well as the compulsory use of renewable energy sources, requiring more detailed and comprehensive calculations of a cost-optimal set of solutions. In this study, a nZEB single-family house is analysed in detail using a comparative global cost calculation methodology. Different insulation materials and construction types, as well as two types of windows and various heating systems, are combined to obtain the same calculated annual energy consumption. The economic calculations of each combination are carried out for the calculation period of 30 years, taking into account expected energy price increase, discount rate, etc. These calculations show the cost-optimal variants, allowing the prediction of a more advantageous selection of materials and system use in a nZEB in terms of the real operation costs.

Do Larger Health Insurance Subsidies Benefit Patients or Producers? Evidence from Medicare Advantage

A central question in the debate over privatized Medicare is whether increased government payments to private Medicare Advantage (MA) plans generate lower premiums for consumers or higher profits for producers. Using difference‑in‑differences variation brought about by a sharp legislative change, we find that MA insurers pass through 45 percent of increased payments in lower premiums and an additional 9 percent in more generous benefits. We show that advantageous selection into MA cannot explain this incomplete pass‑through. Instead, our evidence suggests that market power is important, with premium pass‑through rates of 13 percent in the least competitive markets and 74 percent in the most competitive. (JEL G22, H51, I11, I13, I18)

Advertising and Risk Selection in Health Insurance Markets

This paper studies the impact of advertising as a channel for risk selection in Medicare Advantage. We provide evidence that insurer advertising is responsive to the gains from risk selection. Then we develop and estimate an equilibrium model of Medicare Advantage with advertising, allowing rich individual heterogeneity. Our estimates show that advertising is effective in attracting healthy individuals who are newly eligible for Medicare, contributing to advantageous selection into Medicare Advantage. Moreover, risk selection through advertising substantially lowers premiums by improving insurers' risk pools. The distributional implication is that unhealthy consumers may be better off through cross-subsidization from healthy individuals. (JEL D81, G22, I13, I18, M37)