An empirical examination of risk equalisation in a regulated community rated health insurance market

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dc.contributor.advisor Shinnick, Edward Turner, Brian D. 2013-01-29T09:40:48Z 2013-01-29T09:40:48Z 2010-04 2010
dc.identifier.citation Turner, B. D. 2010. An empirical examination of risk equalisation in a regulated community rated health insurance market. PhD Thesis, University College Cork. en
dc.description.abstract Despite universal access entitlements to the public healthcare system in Ireland, over half the population is covered by voluntary private health insurance. The market operates on the basis of community rating, open enrolment and lifetime cover. A set of minimum benefits also exists, and two risk equalisation schemes have been put in place but neither was implemented. These schemes have proved highly controversial. To date, the debate has primarily consisted of qualitative arguments. This study adds a quantitative element by analysing a number of pertinent issues. A model of a community rated insurance market is developed, which shows that community rating can only be maintained in a competitive market if all insurers in the market have the same risk profile as the market overall. This has relevance to the Irish market in the aftermath of a Supreme Court decision to set aside risk equalisation. Two reasons why insurers’ risk profiles might differ are adverse selection and risk selection. Evidence is found of the existence of both forms of selection in the Irish market. A move from single rate community rating to lifetime community rating in Australia had significant consequences for take-up rates and the age profile of the insured population. A similar move has been proposed in Ireland. It is found that, although this might improve the stability of community rating in the short term, it would not negate the need for risk equalisation. If community rating were to collapse then risk rating might result. A comparison of the Irish, Australian and UK health insurance markets suggests that community rating encourages higher take-up among older consumers than risk rating. Analysis of Irish hospital discharge figures suggests that this yields significant savings for the Irish public healthcare system. This thesis has implications for government policy towards private health insurance in Ireland. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2010, Brian D. Turner en
dc.rights.uri en
dc.subject Healthcare en
dc.subject Health insurance en
dc.subject Community rating en
dc.subject Risk profile en
dc.subject Ireland en
dc.subject Australia en
dc.subject UK en
dc.subject.lcsh Insurance, Health -- Ireland en
dc.title An empirical examination of risk equalisation in a regulated community rated health insurance market en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral en
dc.type.qualificationname PhD (Commerce) en
dc.internal.availability Full text available en
dc.description.version Accepted Version en
dc.description.status Not peer reviewed en Economics en

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© 2010, Brian D. Turner Except where otherwise noted, this item's license is described as © 2010, Brian D. Turner
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