Genetic adverse selection: Evidence from long-term care insurance and Huntington disease

• 成果类型: Article
• 署名作者: Oster, Emily; Shoulson, Ira; Quaid, Kimberly; Dorsey, E. Ray
• 署名单位: University of Chicago; University of Rochester; Indiana University System; Indiana University Bloomington
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2010.06.009
• 发表日期: 2010
• 页码: 1041-1050
• 关键词: Adverse selection; Long-term care insurance; Huntington disease; Genetic testing

摘要

Individual, personalized genetic information is increasingly available, leading to the possibility of greater adverse selection over time, particularly in individual-payer insurance markets. We use data on individuals at risk for Huntington disease (HD), a degenerative neurological disorder with significant effects on morbidity, to estimate adverse selection in long-term care insurance. We find strong evidence of adverse selection: individuals who carry the HD genetic mutation are up to 5 times as likely as the general population to own long-term care insurance. This finding is supported both by comparing individuals at risk for HD to those in the general population and by comparing across tested individuals in the HD-risk population with and without the HD mutation. (C) 2010 Elsevier B.V. All rights reserved.