RT Monograph
SR 00
A1 Cremer, Helmuth
A1 Lozachmeur, Jean-Marie
T1 Nonlinear reimbursement rules for preventive and curative medical care
YR 2024
FD 2024-04
VO 24-1527
SP 28
K1 ex post moral hazard
K1 health insurance
K1 secondary prevention
AB We  study  the  design  of  nonlinear  reimbursement  rules  for  expenses  on  secondary  preventive and on therapeutic care.  With some probability individuals are healthy and do not need any  therapeutic health care.  Otherwise they become ill and their health status (the  severity  of  their  disease)  is  realized  and  identifies  their  ex  post  type.   Preventive care is determined ex ante, that is before the health status is determined while curative care is chosen ex post. Insurance  benefits  depend  on  preventive  and  curative  care  in  a  possibly  nonlinear way, and  marginal  benefits  can  be  positive  or  negative.    In  the  first  best,  achieved when health status is ex post  publicly observable, insurance benefits are fiat (lump sum payments) and do not depend on expenditures.  When the severity of the disease is not observable, so that there is ex post moral hazard, this solution is not incentive compatible (for more healthy individuals). The optimal insurance then implies benefits that increase with both  types of care.  This is because health expenditures reduce informational rents and they are upward distorted.  This relaxes the incentive constraint because less healthy individuals value care more than healthy individuals. Even though preventive care is chosen ex  ante,  when there is no asymmetry of in- formation, it  does have an impact on the incentive constraint and thus on informational rents.  This is due to two concurring effects.  First, prevention is more effective for the more severely ill.  Second, these individuals also have a lower marginal utility of income so that a given level of expenditure on preventive care has less impact on their utility.
T2 TSE Working Paper
PB TSE Working Paper
PP Toulouse
AV Published
LK https://publications.ut-capitole.fr/id/eprint/49336/
UL http://tse-fr.eu/pub/129305