Explaining lapse in long‐term care insurance markets
利用1996-2006年美国健康与退休研究数据，分析了3974名私人长期护理保险持有者的保单失效原因，发现失效者更贫穷、教育程度低、健康状况差，且健康变化影响较小，失效更多是财务和替代选择问题而非健康风险重估。
Expansion of private long-term care insurance (LTCI) is often posited as a potential mechanism to finance long-term care (LTC) for a growing elderly population in the US. One largely ignored issue is lapse or cancellation of policies. Individuals who let a LTCI policy lapse face resumed risk of LTC expenditures while suffering the financial loss of premiums paid. The motivation for lapse has been poorly understood, though some have hypothesized that improvements in health risk may be responsible. We use 1996-2006 Health and Retirement Study data from 3974 respondents who report having private LTCI to estimate baseline and dynamic predictors of lapse and test for ex post adverse selection. Individuals who lapse are generally poorer, less educated, less healthy, and more likely to be racial and ethnic minorities than those who retain their policies. Changes in health status play a relatively small role in lapse, and we find little evidence for adverse selection associated with lapse. We conclude that lapse of LTCI is more an issue of finances and alternatives than a reassessment of health risk. Because lapse rates are highest among the least healthy individuals, lapse should be considered explicitly in efforts to expand the LTCI market.