{"title":"具有逆向选择和预防的健康保险市场基因检测的福利分析","authors":"David Bardey, Philippe De Donder","doi":"10.1111/caje.70010","DOIUrl":null,"url":null,"abstract":"<p>Personalized medicine remains in its early stages, with expensive genetic tests offering limited actionable insights for prevention. As a result, few individuals undergo testing, and health insurance contracts pool all agents regardless of genetic background. However, as tests become cheaper and more informative, more people may choose to get tested, influencing both insurance pricing and contract types. We examine how the proportion of individuals taking genetic tests and the informativeness of these tests affect whether equilibrium contracts remain pooling or become separating. We find that increasing test uptake can reduce welfare, particularly when it leads to a shift from pooling to separating contracts. Similarly, lower prevention effort costs, reflecting more informative tests, can harm welfare if they induce separation. These findings suggest that policies promoting genetic testing or reducing prevention costs may not always be beneficial, especially when the market equilibrium remains in a pooling state.</p>","PeriodicalId":47941,"journal":{"name":"Canadian Journal of Economics-Revue Canadienne D Economique","volume":"58 2","pages":"443-483"},"PeriodicalIF":1.3000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A welfare analysis of genetic testing in health insurance markets with adverse selection and prevention\",\"authors\":\"David Bardey, Philippe De Donder\",\"doi\":\"10.1111/caje.70010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Personalized medicine remains in its early stages, with expensive genetic tests offering limited actionable insights for prevention. As a result, few individuals undergo testing, and health insurance contracts pool all agents regardless of genetic background. However, as tests become cheaper and more informative, more people may choose to get tested, influencing both insurance pricing and contract types. We examine how the proportion of individuals taking genetic tests and the informativeness of these tests affect whether equilibrium contracts remain pooling or become separating. We find that increasing test uptake can reduce welfare, particularly when it leads to a shift from pooling to separating contracts. Similarly, lower prevention effort costs, reflecting more informative tests, can harm welfare if they induce separation. These findings suggest that policies promoting genetic testing or reducing prevention costs may not always be beneficial, especially when the market equilibrium remains in a pooling state.</p>\",\"PeriodicalId\":47941,\"journal\":{\"name\":\"Canadian Journal of Economics-Revue Canadienne D Economique\",\"volume\":\"58 2\",\"pages\":\"443-483\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Economics-Revue Canadienne D Economique\",\"FirstCategoryId\":\"96\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/caje.70010\",\"RegionNum\":4,\"RegionCategory\":\"经济学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Economics-Revue Canadienne D Economique","FirstCategoryId":"96","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/caje.70010","RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ECONOMICS","Score":null,"Total":0}
A welfare analysis of genetic testing in health insurance markets with adverse selection and prevention
Personalized medicine remains in its early stages, with expensive genetic tests offering limited actionable insights for prevention. As a result, few individuals undergo testing, and health insurance contracts pool all agents regardless of genetic background. However, as tests become cheaper and more informative, more people may choose to get tested, influencing both insurance pricing and contract types. We examine how the proportion of individuals taking genetic tests and the informativeness of these tests affect whether equilibrium contracts remain pooling or become separating. We find that increasing test uptake can reduce welfare, particularly when it leads to a shift from pooling to separating contracts. Similarly, lower prevention effort costs, reflecting more informative tests, can harm welfare if they induce separation. These findings suggest that policies promoting genetic testing or reducing prevention costs may not always be beneficial, especially when the market equilibrium remains in a pooling state.
期刊介绍:
The Canadian Journal of Economics (CJE) is the journal of the Canadian Economics Association (CEA) and is the primary academic economics journal based in Canada. The editors seek to maintain and enhance the position of the CJE as a major, internationally recognized journal and are very receptive to high-quality papers on any economics topic from any source. In addition, the editors recognize the Journal"s role as an important outlet for high-quality empirical papers about the Canadian economy and about Canadian policy issues.