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Long-term care risk misperceptions

  • Martin Boyer
  • Philippe De Donder
  • Claude Fluet
  • Marie-Louise LerouxEmail author
  • Pierre-Carl Michaud
Article
  • 12 Downloads

Abstract

This paper reports survey evidence on long-term care (LTC) risk misperceptions and demand for long-term care insurance (LTCI) in Canada. We study three LTC risks: needing help with at least one activity of daily living, needing access to a nursing home, and living to the age of 85. We contrast subjective (stated) probabilities with objective (predicted) probabilities for these three dimensions, and define misperceptions as the differences between them. We first provide descriptive statistics about objective and subjective probabilities. We then analyse how risk misperceptions correlate with individual characteristics and how they affect intentions and actual purchase of LTCI. We find that although misperceptions significantly affect both intention to buy LTCI and actual purchase of LTCI, they cannot explain the low take-up rate of LTCI in our sample. Correcting simultaneously the perceptions of LTC risks on the three dimensions would increase LTCI take-up by at most one percentage point.

Keywords

Long-term care insurance puzzle Disability Misperceptions Subjective probability 

Supplementary material

41288_2018_116_MOESM1_ESM.docx (45 kb)
Supplementary material 1 (DOCX 44 kb)

References

  1. Boisclair, D., A. Côté-Sergent, F. Laliberté-Auger, S. Marchand, and P.-C. Michaud. 2016. A health microsimulation model for Quebec and Canada. Technical report. Montreal: HEC Montreal—CEDIA.Google Scholar
  2. Boyer, M., P. De Donder, C. Fluet, M.-L. Leroux, P.-C. Michaud. 2017. Long-term care insurance: knowledge barriers, risk perception and adverse selection, NBER WP 23918.Google Scholar
  3. Boyer, M.M., P. De Donder, C. Fluet, M.-L. Leroux, P.-C. Michaud. 2018. A Canadian parlor room-type approach to the long-term care insurance puzzle. UQAM Working paper 2018-20.Google Scholar
  4. Brown, J.R., and A. Finkelstein. 2009. The private market for long-term care insurance in the United States: a review of the evidence. The Journal of Risk and Insurance 76 (1): 5–29.CrossRefGoogle Scholar
  5. Canadian Life and Health Insurance Association (CLHIA). “A guide to long term care insurance”. https://www.advocis.ca/Update2018/assets/a-guide-to-long-term-care-insurance%2C-clhia.pdf. Accessed on March 26, 2018.
  6. Coe, N.B., M.M. Skira, and C.H. Van Houtven. 2015. Long-term care insurance: does experience matter? Journal of Health Economics 40: 122–131.CrossRefGoogle Scholar
  7. Costa-Font, J., and M. Costa-Font. 2011. Explaining optimistic old age disability and longevity expectations. Social Indicators Research 104 (3): 533–544.CrossRefGoogle Scholar
  8. Costa-Font, J., and C. Courbage (eds.). 2012. Financing long-term care in Europe: institutions, markets and models. Basingstoke, U.K: Palgrave Macmillan.Google Scholar
  9. Courbage, C., and N. Roudaut. 2008. Empirical evidence on long-term care insurance purchase in France. The Geneva Papers on Risk and Insurance—Issues and Practice 33 (4): 645–658.CrossRefGoogle Scholar
  10. Courbage, C., and N. Roudaut. 2011. Long-term care insurance: the French example. European Geriatric Medicine 2 (1): 22–25.CrossRefGoogle Scholar
  11. DeDonder, P., and M.-L. Leroux. 2013. Behavioral biases and long term care annuities: a political economy approach. The B.E. Journal of Economic Analysis & Policy 14 (2): 551–575.Google Scholar
  12. Finkelstein, A., and K. McGarry. 2006. Multiple dimensions of private information: evidence from the long-term care insurance market. American Economic Review 96 (4): 938–958.CrossRefGoogle Scholar
  13. Goldman, D.P., B. Shang, J. Bhattacharya, A.M. Garber, M. Hurd, G.F. Joyce, D.N. Lakdawalla, C. Panis, and P.G. Shekelle. 2005. Consequences of health trends and medical innovation for the future elderly. Health Affairs 24 (Suppl2): W5R5.CrossRefGoogle Scholar
  14. Hakes, J.K., and W.K. Viscusi. 1997. Mortality risk perceptions: a bayesian reassessment. Journal of Risk and Uncertainty 15: 135–150.CrossRefGoogle Scholar
  15. Hamermesh, D.S. 1985. Expectations, life expectancy and economic behavior. The Quarterly Journal of Economics 100 (2): 389–408.CrossRefGoogle Scholar
  16. Hurd, M.D., and K. McGarry. 2002. The predictive validity of subjective probabilities of survival. The Economic Journal 112 (482): 966–985.CrossRefGoogle Scholar
  17. Hurd, M.D. 2009. Subjective probabilities in household survey. Annual Review of Economics 1: 543–562.CrossRefGoogle Scholar
  18. Hurd, M.D., P.-C. Michaud, and S. Rohwedder. 2017. Distribution of lifetime nursing home use and of out-of-pocket spending. Proceedings of the National Academy of Sciences United States of America 114 (37): 9838–9842.CrossRefGoogle Scholar
  19. Ludwig, A., and A. Zimper. 2007. A parsimonious model of subjective life expectancy. MEA discussion paper series, University of Manheim, pp. 2007–2065.Google Scholar
  20. OECD. 2011. Help wanted? Providing and paying for long-term care, OECD Health Policy Studies. http://www.oecd.org/els/health-systems/help-wanted-9789264097759-en.htm.
  21. Pauly, M.V. 1990. The rational nonpurchase of long-term-care insurance. Journal of Political Economy 98 (1): 153–168.CrossRefGoogle Scholar
  22. Pestieau, P., and G. Ponthière. 2012. Long term care insurance puzzle. In Financing long-term care in Europe—institutions, markets and models, ed. J. Costa-Font and C. Courbage. Basingstoke: Palgrave Macmillan Edition.Google Scholar
  23. Post, T., and K. Hanewald. 2013. Longevity risk, subjective survival expectations, and individual saving behavior. Journal of Economic Behavior & Organization 86: 200–220.CrossRefGoogle Scholar
  24. Riddel, M., and D. Hales. 2018. Risk misperceptions and selection in insurance markets: An application to demand for cancer insurance. The Journal of Risk and Insurance 85 (3): 749–785.CrossRefGoogle Scholar
  25. Viscusi, W.K. 1985. A bayesian perspective on biases in risk perception. Economic Letters 17 (1–2): 59–62.CrossRefGoogle Scholar
  26. Zhou-Richter, T., M. Browne, and H. Gründl. 2010. Don’t they care? Or, are they just unaware? Risk perception and the demand for long-term care insurance. The Journal of Risk and Insurance 77 (4): 715–747.CrossRefGoogle Scholar

Copyright information

© The Geneva Association 2018

Authors and Affiliations

  • Martin Boyer
    • 1
  • Philippe De Donder
    • 2
  • Claude Fluet
    • 3
  • Marie-Louise Leroux
    • 4
    Email author
  • Pierre-Carl Michaud
    • 1
  1. 1.HEC MontréalMontréalCanada
  2. 2.ESG UQAMMontréalCanada
  3. 3.Université LavalMontréalCanada
  4. 4.Department of Economics, Ecole des Sciences de Gestion (ESG)University of Québec at Montréal (UQAM)MontréalCanada

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