2016 Benjamin Handel, Igal Hendel and Michael Whinston "Equilibria in Health Exchanges: Adverse ..." скачать в хорошем качестве

2016 Benjamin Handel, Igal Hendel and Michael Whinston "Equilibria in Health Exchanges: Adverse ..."

Benjamin Handel, Igal Hendel & Michael Whinston “Equilibria in Health Exchanges: Adverse Selection versus Reclassification Risk” How do you design a health insurance market that protects people when they get sick — without causing the market to unravel? Health insurance markets are vulnerable to adverse selection: individuals with higher expected medical costs are more likely to purchase generous coverage. But another risk looms in dynamic settings — reclassification risk — the possibility that premiums rise sharply after a health shock. Handel, Hendel, and Whinston developed a dynamic equilibrium model of regulated health insurance exchanges that incorporates both forces. Their framework includes heterogeneous risk types, health transitions over time, insurer competition, and plan choice under regulation. By structurally estimating preferences and market parameters using detailed insurance data, they quantified the tradeoff between limiting adverse selection and providing long-term insurance against health reclassification. The key insight is that policies designed to mitigate one inefficiency can exacerbate another. Regulations that protect consumers from premium increases may intensify adverse selection. The welfare implications depend on the dynamic balance between these forces. The 2016 Frisch Medal recognized a major advance in health economics and industrial organization. Insurance markets must be understood as dynamic equilibrium systems, not static partial equilibria. This work set a new standard for evaluating health policy in complex regulated markets.