Thesis (Ph. D.)--Illinois State University, 1989. / Title from title page screen, viewed Oct. 3, 2005. Dissertation Committee: Mary Ann Lynn, Ronald S. Halinksi (co-chairs), Robert L. Arnold, Calvin C. Jackson, Rodney P. Riegle. Additional title from abstract: Self-insured employee health plans in Illinois public school districts. Includes bibliographical references (leaves 166-171) and abstract. Also available in print.

Inaug.-diss.--Göttingen.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1973. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis advisor: Michael D. Grubb / The first chapter studies behavioral mechanisms to expand health insurance coverage. In health insurance markets where regulators limit insurers' ability to price on the health status of individuals, a traditional regulatory intervention to protect the market from adverse selection and expand coverage among young and healthy people is mandating insurance coverage. In this chapter, I analyze an alternative, behavioral mechanism in the context of the Affordable Care Act Marketplaces: the automatic enrollment of the uninsured with possible opt-out. I build a theoretical model which shows that this nudging policy increases coverage rates, and the size of its benefit depends on the strength of consumer inertia. Using an individual-level panel dataset on health insurance plan choice and claims, I estimate a structural model of health insurance demand and supply in the presence of switching costs. Simulating the effects of the policy, I find that auto-enrollment can increase enrollment rates by over 60% and reduce annual premiums by $300. Moreover, I show that taking into account the heterogeneity of preferences is essential when designing default plans for auto-enrolled consumers. Defaulting everyone into the same contract type leads to more quitting due to inefficient matching and it may also indirectly increase adverse selection on the intensive margin through the price adjustment mechanism. The results of this paper suggest that in order to avoid these problems and maximize the benfits of auto-enrollment in selection markets, it is important to design smart default policies. The second chapter explores how changes in cost sharing affect consumers' demand for health care. Cost sharing reduction (CSR) subsidies are a less well-known provision of the Affordable Care Act (ACA) that aimed to make private health insurance coverage more affordable. These subsidies discontinuously increase the share of expenses paid by the insurer as enrollee income crosses the eligibility cutoffs. This specific subsidy design provides a unique setting to identify moral hazard in health care utilization from observational data that is a major empirical challenge in the literature. In this chapter, I combine individual-level post-subsidy premium data from an All Payer Claims Database with information on plan-level base prices to recover the amount of the premium subsidy. Applying the ACA's premium subsidy formula backwards, I am able to estimate family income. Using this imputed income, I exploit a sharp regression discontinuity design to study the impact of changes in actuarial value on consumer behavior. I find significant increases in health care utilization at income levels associated with the CSR subsidy eligibility cutoffs. These results imply that individuals tend to use more health care services only due to the fact that the insurer becomes responsible for a larger share of their expenditures. These results provide insights about the price elasticity of demand for medical care in a new context. The third chapter evaluates the impact of the ACA on HPV vaccination. Rates of completion of the HPV vaccine series remain suboptimal in the US. The effects of the ACA on HPV vaccine completion are largely unknown. The aim of this study was to examine the associations between the ACA's 2010 provisions and 2014 insurance expansions with HPV vaccine completion by sex and health insurance type. Using 2009-2015 public and private health insurance claims, we conducted a logistic regression model to examine the associations between the ACA policy changes with HPV vaccine completion as well as interactions by sex and health insurance type. Among females and males who initiated the HPV vaccine, 27.6% and 28.0%, respectively, completed the series within 12 months. Among females, the 2010 ACA provision was associated with increases in HPV vaccine completion for the privately-insured and Medicaid enrollees. The 2014 health insurance expansions were associated with increases in vaccine completion for females with private insurance and Medicaid. Among males, the 2014 ACA reforms were associated with increases in HPV vaccine completion for the privately-insured and Medicaid enrollees. Despite low HPV vaccine completion overall, both sets of ACA provisions increased completion among females and males. Our results suggest that expanding Medicaid across the remaining states could increase HPV vaccine completion among publicly-insured youth and prevent HPV-related cancers. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Economics.

Thesis advisor: Michael Grubb / This dissertation addresses questions in the health insurance and industrial organization fields. In the first chapter, I investigate how gender-based pricing bans affect health insurance markets offering long-term contracts. In thesecond chapter, I examine lapsing, and its implications, in a health insurance market offering long-term contracts. In the third chapter, I study the long-term implications of product unavailability in the beer market. Chapter 1: In theory, guaranteed renewable (GR) insurance contracts can efficiently insure against reclassification risk without causing adverse selection on pre-existing conditions. In practice, however, adverse selection can still arise on other dimensions. In 2020, in response to protests demanding gender equality, Chile banned gender-based pricing in its private health insurance market. I investigate how this policy impacts Chile’s health care system, which consists of a low-quality public option and a private market characterized by the use of GR contracts. I find that, if the ban is implemented, prices in the private market would increase as low-cost men switch to the public option and high-cost women enter. Overall, the regulation causes a shift of surplus from men to women. The ban is regressive, as high-income groups benefit more than low-income groups, creating a trade-off between gender-based equity and income-based equity. Subsidies that induce low-cost enrollees to remain in the private market are the most effective mitigation strategy to contain higher premiums. Finally, relative to non-GR contracts, the number of individuals choosing the private market is lower under guaranteed renewability. Chapter 2: Guaranteed renewable (GR) insurance contracts have the potential to efficiently protect individuals against reclassification risk without the negative side effects of price regulation, such as adverse selection. For these contracts to work properly, consumers must pay front-loaded premiums when healthy and stick with their contracts for many years in order to subsidize their future high-risk selves. This paper studies lapsing in the Chilean private health insurance markets, a system characterized by the offering of GR contracts. I find that most policyholders lapse their insurance plans just a few years after signing their contracts. I show that policies and lapse patterns predicted by standard theoretical models of long-term contracts are the opposite of those observed empirically. Finally, premiums increasing over time, and consumers lapsing their contracts because of those price changes, are a key determinant of insurers’ profits. Chapter 3: The marketing literature has investigated the processes potentially leading to brand building and the benefits these brands may enjoy over time. One of those possible benefits is resilience in the face of a reputational challenge or a crisis. This chapter focuses on the long-term implications of product unavailability. We leverage a quasi-natural experiment that exogenously removed the top leading beer brands from retail stores for several weeks. We test whether these prolonged stockouts can erode market shares beyond the current or subsequent purchase occasions and study the potential mechanisms at play. Using panel data of consumer purchases before and after the product shortage, we observe that the top brands only partially recovered their pre-stockout market shares, especially among their most frequent buyers. We identify a sizable portion of consumers who tried small brands for the first time during the stockout period and remained to buy those products persistently. To control for prices, state dependence, and product availability, we estimate a choice model with heterogeneous preferences and find that exposure to stockouts has long-run effects on purchase behavior. We interpret our estimates as evidence that consumers facing a restricted choice set may learn or become aware of competing products with long-lasting consequences on preferences. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Economics.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

by Lo Ming Ngai, Wong Tai Wai. / Thesis (M.B.A.)--Chinese University of Hong Kong, 1990. / Bibliography: leaves 76-78. / ABSTRACT --- p.ii / TABLE OF CONTENTS --- p.iii / ACKNOWLEDGMENT --- p.iv / Chapter I. --- HEALTH CARE SYSTEM AND HEALTH INSURANCE / Introduction --- p.1 / Function of Health Insurance --- p.4 / History of Contract Medicine & Health Insurance in HK --- p.6 / The Present Health Insurance Market in HK --- p.7 / Medical Services in HK --- p.10 / Scott's Report --- p.12 / Provisional Hospital Authority Report --- p.15 / Chapter II. --- POSSIBLE SCENARIOS FOR HEALTH CARE FINANCING --- p.19 / Chapter III. --- RESEARCH METHODOLOGY --- p.31 / The Delphi Methodology --- p.33 / Questionnaire Design --- p.39 / Selection of Panel --- p.42 / Collection of Data --- p.43 / Chapter IV. --- RESULTS AND DISCUSSION --- p.44 / Chapter V. --- IMPLICATIONS AND CONCLUSIONS --- p.60 / APPENDICES --- p.75 / "Questionnaires for Round 1,2,3" / "Results for Round 1,2,3" / Comments from panelists / Medical Expenditure in recent 10 years / Medical Expenditure Forecast / Medical Benefits for Employees in HK / "Analysis of General Insurance Business,1986,1987" / BIBLIOGRAPHY --- p.76

Thesis (doctoral)--Universität, Jena, 2003. / Originally presented as the author's thesis (doctoral)--Friedrich-Schiller-Universität Jena, Wintersemester 2002/2003. Includes bibliographical references (p. [240]-249) and index.

published_or_final_version / Public Health / Master / Master of Public Health

M.Com. (Business Management) / The success of National Health Insurance (NHI) according to literature depends on a number of factors; this includes awareness and knowledge of the benefit of the policy by the public, and the increase and equitable utilisation of the healthcare facilities once the policy is promulgated into a law. The aim of this study is to provide insight into what the effect of government communication and public debate has been on creating awareness and building knowledge on the NHI subject amongst university students, and to establish the attitude and readiness status of students to utilize the NHI platform to access healthcare service. A cross-sectional, descriptive, empirical survey was conducted amongst a sample of one hundred and thirteen (n=113) students at the University of Johannesburg to address the research questions. The survey used self-administered questionnaires to gather primary quantitative data. This study deployed rigorous statistical analysis that included both descriptive and inferential statistical analyses methods. Findings from this study revealed that the majority of the students are aware of NHI; albeit possess a low level of functional knowledge on the subject. The majority of the students prospectively show less preference to use NHI to access health compared to using medical aids, and this is more apparent amongst the male students. From this study, undergraduates show more preference to use NHI over medical aids to access healthcare than postgraduate students. This insight about university students will inform policy makers and businesses on how to develop communication and engagement strategies geared at achieving success on NHI development and healthcare access. The study acknowledges the limitations of a small sample size, and the influence of the respondents’ family socio-economic standing on their attitude to NHI as a healthcare access platform.