Genetic adverse selection: Evidence from long-term care insurance and Huntington disease

Journal of Public Economics

Volumn 94, Issue 11-12, 2010, Pages 1041-1050

  Oster, Emily ^a,b   Shoulson, Ira ^c   Quaid, Kimberly ^d   Dorsey, E Ray ^c  

^a UNIVERSITY OF CHICAGO   (United States)

^b NATIONAL BUREAU OF ECONOMIC RESEARCH   (United States)

^c UNIVERSITY OF ROCHESTER   (United States)

^d INDIANA UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Adverse selection; Genetic testing; Huntington disease; Long term care insurance

Indexed keywords

EID: 78049477289     PISSN: 00472727     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jpubeco.2010.06.009     Document Type: Article

References (41)

1. Aktan-Collan K., Katja, Haukkala A., Kaariainen H. Life and health insurance behaviour of individuals having undergone a predictive genetic testing programme for hereditary non-polyposis colorectal cancer. Community Genetics 2001, 4(4):219-224.
2. Armstrong K., et al. Life insurance and breast cancer risk assessment: adverse selection, genetic testing decisions, and discrimination. American Journal of Medical Genetics Part A 2003, 120A(3):359-364.
3. Bolt J. Huntington's chorea in the West of Scotland. British Journal of Psychiatry 1970, 116(532):259-270.
4. Brown J., Finkelstein A. Why is the market for long term care insurance so small. Journal of Public Economics 2007, 91(10):1967-1991.
5. Brown J., Finkelstein A. The private market for long-term care insurance in the U.S.: a review of the evidence. Journal of Risk and Insurance 2009, 76(1):5-29.
6. Burton P., et al. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature 2007, 447(7145):661-678.
7. Cawley J., Philipson T. An empirical examination of information barriers to trade in insurance. American Economic Review 1999, 89(4):827-846.
8. Chiappori P.-A., Salanie B. Testing for asymmetric information in insurance markets. Journal of Politcal Economy 2000, 108(1):56-78.
9. Cochrane J. Health-status insurance: how markets can provide health security. Policy Analysis 2009, (633).
10. Cohen A., Einav L. Estimating risk preferences from deductible choice. American Economic Review 2007, 97(3):745-788.
11. Cutler D., Finkelstein A., McGarry K. Preference heterogeneity in insurance markets: explaining a puzzle. American Economic Review Papers and Proceedings 2008, 98(2):157-162.
12. De Meza D., Webb D. Advantageous selection in insurance markets. RAND Journal of Economics 2001, 32:249-262.
13. Doherty N., Thistle P. Adverse selection with endogenous information in insurance markets. Journal of Public Economics 1996, 63(1):83-102.
14. Einav L., Finkelstein A., Schrimpf P. Optimal mandates and the welfare cost of asymmetric information: evidence from the U.K. annuity market. NBER Working Paper 2009, No. 13228.
15. Fang H., Keane M., Silverman D. Sources of advantageous selection: evidence from the Medigap insurance market. Journal of Political Economy 2008, 116(2):303-350.
16. Finkelstein A., Poterba J. Adverse selection in insurance markets: policyholder evidence from the U.K. annuity market. Journal of Political Economy 2004, 112(1):183-208.
17. Finkelstein A., McGarry K. Multiple dimensions of private information: evidence from the long-term care insurance market. American Economic Review 2006, 96(4):938-958.
18. Harper P. Huntington's Disease 1996, WB Saunders.
19. Hoel M., Iversen T. Genetic testing when there is a mix of compulsory and voluntary health insurance. Journal of Health Economics 2002, 21(2):253-270.
20. Hoy M., Witt J. Welfare effects of banning genetic information in the life insurance market: the case of BRCA1/2 genes. Journal of Risk and Insurance 2007, 74(3):523-546.
21. Hoy M., Polborn M. The value of genetic information in the life insurance market. Journal of Public Economics 2002, 78(3):235-252.
22. Hoy M., Orsi F., Eisinger F., Moatti J.P. The impact of genetic testing on healthcare insurance. Geneva Papers on Risk and Insurance 2003, 28(2):203-221.
23. Huntington Study Group PHAROS Investigators At risk for Huntington disease: the PHAROS prospective Huntington at risk observational study cohort enrolled. Archives of Neurology 2006, 63:991-996.
24. MacMinn R., Brockett P. Genetic Testing and Adverse Selection. Illinois State University Working Paper 2004.
25. McCarthy D., Mitchell O. International Adverse Selection in Life Insurance and Annuities. NBER Working Paper 9975 2003.
26. Meyer B., Sullivan J. Further Results on Measuring the Well-Being of the Poor Using Income and Consumption. NBER Working Paper No. 13413 2007.
27. Meyers R.H. Huntington's disease genetics. NeuroRx 2004, 1:255-262.
28. Nance M.A., Saunders G. Characteristics of individuals with Huntington disease in long-term care. Movement Disorders 1996, 11(5):542-548.
29. Oster E., Dorsey E.R., Bausch J., Shinaman A., Kayson E., Oakes D., Shoulson I., Quaid K. Fear of health insurance loss among individuals at risk for Huntington disease. American Journal of Medical Genetics, Part A 2008, 146(16):2070-2077.
30. Pauly M., Withers K., Viswanathan K., Lemaire J., Hershey J., Armstrong K., Asch D. Price Elasticity of Demand for Term Life Insurance and Adverse Selection. NBER Working Paper No. 9925 2003.
31. Smart M. Competitive insurance markets with two unobservables. International Economic Review 2000, 41(1):153-169.
32. Strohmenger R., Wambach A. Adverse selection and categorical discrimination in the health insurance markets: the effects of genetic tests. Journal of Health Economics 2000, 19(2):197-218.
33. Subramanian K., Lemaire J., Hershey J., Pauly M., Armstrong K., Asch D. Estimating adverse selection costs from genetic testing for breast and ovarian cancer: the case of life insurance,. Journal of Risk and Insurance 1999, 66(4):531-550.
34. Taylor D., Cook-Deegan R., Hiraki S., Scott Roberts J., Blzer D., Green R. Will APOE risk assessment for Alzheimer's disease affect private long term care insurance coverage rates?. Duke University Working Paper 2009.
35. United States House of Representatives Genetic Information Non-Discrimination Act. Federal Law 2007.
36. United States Senate The Patient Protection and Affordable Care Act. Federal Law 2010.
37. Viswanathan K., Lemaire J., Withers K., Armstrong K., Baumritter A., Hershey J., Pauly M., Asch D. Adverse selection in term life insurance purchasing due to the BRCA1/2 genetic test and elastic demand. Journal of Risk and Insurance 2007, 74(1):65-86.
38. Walker D.A., HArper P.S., Wells C.E.C., Tyler A., Davies K., Newcombe R.G. Huntington's chorea in South Wales: a genetic and epidemiological study. Clinical Genetics 1981, 19:213-221.
39. Walker F. Huntington's disease. Lancet 2007, 359:218-228.
40. Zick C., et al. Genetic testing, adverse selection, and the demand for life insurance. American Journal of Medical Genetics Part A 2000, 93(1):29-30.
41. Zick C., et al. Genetic testing for Alzheimer's disease and its impact on insurance purchasing behavior. Health Affairs 2005, 24(2):483-490.