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12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

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Page 1: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance
Page 2: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

12.5 The Problem with Insurance: Moral Hazard

Social Insurance: The New Function of Government

12.3 Other Reasons for Government Intervention in Insurance Markets

12.2 Why Have Social Insurance? Asymmetric Information and Adverse Selection

12.1 What Is Insurance and Why Do Individuals Value It?

Chapter 12

12.4 Social Insurance Versus Self-Insurance: How Much

Consumption Smoothing?

12.6 Putting It All Together:

Optimal Social Insurance

12.7 Conclusion

In the preamble to the United States Constitution, the framers wrote that they were uniting the states in order to “provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity.”

For most of the country’s history “common defense,” was the federal government’s clear spending priority.

Since then, the government’s spending priorities shifted dramatically, away from “common defense” and toward promoting “the general welfare.”

Page 3: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Important Social Insurance Programs Social Security Unemployment insurance Disability Insurance Workers Compensation Medicare

Page 4: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Public Finance and Public Policy Jonathan Gruber Third Edition Copyright © 2010 Worth Publishers 4 of 29

C H A P T E R 1 2 ■ S O C I A L I N S U R A N C E : T H E N E W F U N C T I O N O F G O V E R N M E N T

Page 5: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Common features of Social Insurance programs Contributions are mandatory A measurable, enabling event Benefits are not related to one’s

income or assets (not means tested)

Page 6: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Understanding the economics of insurance markets

Why individuals value insurance Why insurance markets may fail

Adverse selection Moral hazard

What tradeoffs in designing social insurance

Page 7: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Key terms Adverse selection—the insured

individual knows more about their own risk level than does the insurer

Moral hazard---when you insure against adverse events, you can encourage adverse behavior.

Page 8: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Why insurance Insurance premium---paid to insurer In return, insurer promises payment

to individual if adverse event happens Examples: Health, car, property, farm

crops,

Page 9: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Why do individuals value insurance?

Individuals value because of Diminishing marginal utility

Ie. They choose 2 years of smooth income over 1 year of high consumption and 1 year of starving --because excessive consumption does not

raise utility as much as starvation lowers it. They prefer to smooth out consumption

Page 10: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Why individuals value insurance?

When outcomes are uncertain, individuals wish to smooth their consumption over possible states of the world

Examples: State1: get hit by a car State2: not getting hit

Goal is to make choice today that determines consumption in future for each of these states

Page 11: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Insurance, contd.

Consumers smooth by using some of today’s income to insure against adverse outcome tomorrow.

Basic insurance theory suggests that individuals will demand full insurance to smooth their consumption across states of the world.

Same consumption possible whether accident occurs or not

Page 12: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Expected Utility Model

EU = (1-p) U(C0) + pU(C1)Where

•p stands for the probability of an adverse event

•C0 and C1 stand for consumption in the good and bad states of the world

Page 13: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Analyzing an individual’s demand for insurance

Assume, a 1% chance for and accident with $30,000 of damages

Sam can insure some, none, or all of these medical expenses

Policy cost: m cents per $1 of coverage A policy pays $b for an accident His premium is $mb

Full insurance: m x $30,000 State 0: $mb poorer State 1: $b-$mb richer than if he doesn’t buy

insurance

Page 14: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Expected utility model Sam’s desire to buy depends on price of

insurance An actuarially fair premium sets the price

charged equal to the expected payout $30,000 x .01 = $300 (act. fair prem.)

Page 15: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Expected (Utility) Decision to buy insurance also affected by

risk preference Assume a utility function U= √C.

C0= 30,000 Without insurance: .99√30,000+.01 √0 =171.5 With actuarially fair insurance: .99√29,700 + .01√29,700 = 172.3 Utility is higher with insurance Partial insurance is lower utility

Page 16: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Table 1

The expected utility model

If Sam … And Sam is …

Consumption

Utility √C

Expected utility

Doesn’t buy insurance

Not hit by a car (D=99%)

$30,000

173.20.99x173.2 + 0.01x0 = 171.5

Hit by a car (D=1%) 0 0

Buys full insurance(for $300)

Not hit by a car (D=99%)

$29,700

172.30.99x172.3 + 0.01x172.3 = 172.3

Hit by a car (D=1%)$29,700

172.3

Buys partial insurance(for $150)

Not hit by a car (D=99%)

$29,850

172.8

0.99x172.8 + 0.01x121.8 = 172.2

Hit by a car (D=1%)$14,850

121.8

Page 17: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Result implications Even if insurance is expensive, if

premium is actuarially fair, individuals will want to insure against adverse events.

Implication: The efficient market outcome is full

insurance and thus full consumption smoothing

Page 18: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Role of risk aversion Risk aversion: extent to which an

individual is willing to bear risk Risk averse individuals have a rapidly

diminishing marginal utility of consumption

Individuals with any degree of risk aversion will buy insurance priced fairly.

If not priced fairly, they will not buy

Page 19: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Why have social insurance? Asymmetric information

Insurance markets have information asymmetry between individuals and insurers

Individual knows more about their likelihood of an accident than insurer

Example: Health: the individual knows more about

their health history Insurer is reluctant to sell an actuarially fair

policy to a person with “high risk”

Page 20: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Asymmetric Information Ex. 2 groups of 100 people

1st has 5% chance of injury 2nd has .5% chance

Table 2---results People have the option of buying

insurance and will do so for fair deal Only high risks take policy loses

money

Page 21: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Why Have Social Insurance? Asymmetric Information and Adverse Selection

12 . 2

Example with Full InformationExample with Asymmetric Information

Page 22: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Adverse Selection Problem Insurance market fails because of adverse

selection: Individuals know more about their risks than

insurance company Only those with high chance of adverse

outcome, or if premium is a fair deal, buy insurance

Adverse selection causes insurance companies to lose money

?should we mandate buying insurance? Example (HIV, pre-existing condition,

Page 23: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Will asymmetric information lead to Market Failure?

Not if: Most individuals are fairly risk averse (ie they

will buy an actuarially unfair policy) Policy has a risk premium above the actuarially

fair price This leads to a pooling equilibrium where people

buy insurance even though it is not fairly priced to all individuals

Insurance companies can offer separate products at different prices Consumers reveal info on their riskiness Separating equilibrium- for different individuals

Page 24: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Asymmetric information Separating equilibrium leads to a

market failure Insurers force low risks to choose

between expensive (unfair) full insurance or partial low cost insurance

Low risk group do not get full insurance—suboptimal

University health policy options

Page 25: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

How does government address adverse selection problem?

It could: Impose a mandate that everyone buy

private insurance ($825 per policy) Offer insurance directly

Both options have low risks subsidizing high risks

Page 26: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Other reasons for government intervention Externalities

Negative health externalities Administrative costs

Economies of scale in administration Redistribution

With full information (genetic testing), insurers can identify high risks

Fairness of this discrimination? Paternalism

Individuals won’t insure unless govt. forces Government failure is refraining from helping

Page 27: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Other ways to smooth consumption Self-insurance (Unemployment ex.)

Own savings Labor supply of family Borrowing from friends charity

Government Unemployment Insurance crowds out private provision No gain from government action Efficiency costs from raising government rev.

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Page 29: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Example: Unemployment Insurance

The UI replacement rate is the ratio of unemployment insurance benefits to pre-unemployment earnings.

Figure 2aFigure 2a shows some examples of the possible relationship between the UI replacement rate and the drop in consumption when a person becomes unemployed.

A larger fall in consumption means less consumption smoothing.

Page 30: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance
Page 31: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Example: Unemployment Insurance

Panel A shows the scenario in which a person has no self-insurance (e.g., no savings, credit cards, or friends who can loan money to her). With no UI, consumption falls by 100%. Each percent of wages replaced by UI benefits

reduces the fall in consumption by 1%, shown by the slope equal to 1 in panel A.

In this case, UI plays a full consumption smoothing role: there is no crowd-out of self-insurance (because there is no self-insurance).

Each $1 of UI goes directly to reducing the decline in consumption from unemployment.

Page 32: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Example: Unemployment Insurance

Consider the other extreme, in panel C. A person has full insurance (perhaps private UI or rich parents). With no UI, consumption falls by 0%. Each percent of wages replaced by UI benefits does

not reduce the fall in consumption at all, as shown by the slope equal to 0 in panel C.

In this case, UI plays no full consumption smoothing role, and plays only a crowd-out role.

Each $1 of UI simply means that there is one less dollar of self-insurance.

Page 33: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Example: Unemployment Insurance

In a middle-ground case (Panel B), UI plays a partial consumption-smoothing role.

It is both smoothing consumption and crowding out the use of self-insurance.

Figure 2bFigure 2b summarizes these lessons. The UI consumption smoothing and crowding-out effects depend on the availability of self-insurance.

Page 34: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Lessons for Consumption-Smoothing Role of Social

Insurance

In summary, the importance of social insurance programs for consumption smoothing depends on: The predictability of the event. The cost of the event. The availability of other forms of

consumption smoothing.

Page 35: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

THE PROBLEM WITH INSURANCE: MORAL HAZARD

When governments intervene in insurance markets, the analysis is complicated by moral hazard, the adverse behavior that is encouraged by insuring against an adverse event.

Page 36: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

THE PROBLEM WITH INSURANCE: MORAL HAZARD

Consider the Worker’s Compensation program, for example. Clearly, getting injured on the job is the kind

of event we want to insure against. It is difficult, however, to determine whether

the injury was really on-the-job or not. The insurance payouts include both medical

costs of treating the injury, and cash compensation for lost wages.

Under these circumstances, being “injured” on the “job” starts to look attractive.

Page 37: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

THE PROBLEM WITH INSURANCE: MORAL HAZARD

By trying to insure against a legitimate event, the program may actually encourage individuals to fake injury.

Nonetheless, moral hazard is an inevitable cost of insurance, either private or social. Because of optimizing behavior, we increase the incidence of bad events simply by insuring against them.

Page 38: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

What Determines Moral Hazard?

The factors that determine moral hazard include how easy it is to detect whether the adverse event happened and how easy is it to change one’s behavior to establish the adverse event.

Page 39: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Flood Insurance and the Samaritan’s Dilemma

A P P L I C A T I O N

When a disaster hits, the government will transfer resources to help those affected. Since individuals know that the government will bail them out if things go badly, they will not take precautions against things going badly.To reduce taxpayer-funded federal expenditures on flood control, the federal government established the National Flood Insurance Program (NFIP) in 1968.

• Areas with a 1% chance of flooding in any given year are given the option of buying flood insurance through the program.

• Following Hurricane Katrina, it was revealed that nearly half of the victims did not have flood insurance. The claims from those who did have flood insurance bankrupted the program.

• Failures of the NFIP have many sources. Among these is that many individuals opt out of paying for insurance.

This is a classic example of the Samaritan’s Dilemma: If the government is going to continue to help individuals in disasters, and people are not required by law to buy flood insurance, then why buy it?A solution to this problem would be to mandate the purchase of flood insurance at actuarially fair prices in areas at risk of flooding.

Page 40: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Moral Hazard Is Multidimensional

Moral hazard can arise along many dimensions. In examining the effects of social insurance, four types of moral hazard play a particularly important role: Reduced precaution against entering the adverse

state. Increased odds of entering the adverse state. Increased expenditure when in the adverse state. Supplier responses to insurance against the

adverse state.

Page 41: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

PUTTING IT ALL TOGETHER:OPTIMAL SOCIAL

INSURANCE There are four basic lessons:

First, individuals value insurance and would ideally like to smooth consumption.

Second, insurance markets may fail to emerge, primarily because of adverse selection.

Third, private consumption smoothing mechanisms may be available; to the extent they are, one must examine new consumption smoothing versus crowding out of existing self-insurance.

Fourth, expanding insurance encourages moral hazard.

Page 42: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

PUTTING IT ALL TOGETHER:OPTIMAL SOCIAL

INSURANCE These lessons have policy implications. First, social insurance should be partial.

Full insurance will almost always encourage adverse behavior.

Second, social insurance should be more generous for unpredictable, long-term events where there is less room for private consumption smoothing.

Third, more moral hazard should lead to less insurance.

Page 43: 12.5 The Problem with Insurance: Moral Hazard Social Insurance: The New Function of Government 12.3 Other Reasons for Government Intervention in Insurance

Recap of Social Insurance:The New Function of

Government

What is Insurance and Why Do Individuals Value it?

Why Have Social Insurance? Social Insurance versus Self Insurance:

How Much Consumption Smoothing The Problem with Insurance: Moral

Hazard Putting it All Together: Optimal Social

Insurance