Pandemics and the Individual Life Insurance Market: Evidence of the Impact of COVID-19

COVID-19 has led to significant loss of life and has adversely impacted the worldwide economy. While anecdotal evidence indicates a growing interest in life insurance among U.S. consumers during the pandemic, little is known about how the pandemic may have affected the life insurance market. We utilize insurer-state data to create a measure that captures an insurer's exposure to COVID in each state in which it conducts business. Using this measure to examine the impact of the pandemic on the market for individual life insurance, we find that greater insurer-state COVID exposure is associated with smaller changes in issuances and surrenders in the U.S. We also find that observations with the greatest COVID exposure are more likely to experience declines in issuance and surrender activity. These results indicate that insurers were deliberate with respect to their policy issuance decisions while policyholders kept their policies in force during a period of significant uncertainty. [Key words: COVID-19;life insurance;pandemics;policy issuances;policy surrenders.] JEL Classifications: D12, D22, G22

Estimating Medical Insurance Cost using Linear Regression with HyperParameterization, Decision Tree and Random Forest Models

The total health expenditure refers to the total public and private funds spent on health services and amenities, medical and surgical bills and all other healthcare facilities provided. The financing for health is of great significance and plays a crucial role in health systems. To enhance the productivity of human capital, the efficiency and delivery of healthcare services must be uplifted. Reports have shown that from year 2000 to 2018 there had been a gradual escalation of global health expenses and is standing on around 10% of the total GDP of the world. Out of pocket expenses are also high in least developed nations that have lower per capita income. Even though the World Health Organization (WHO) sanctions loans to these countries, these nations are bound to use the money on industrialization only and not their healthcare, education and public welfare sectors. With inflation, the expenses of first-rate healthcare are also rising which makes it fundamental to have health and life insurance plans. Health insurance schemes insured around 514 million people in India in the year 2021, most of which were covered under government schemes only. Since the advent of COVID-19 people have realized the need for having a insurance plan. Most of the companies that are based on the health insurance sector use predictive modelling to improve their services and business process. Machine Learning (ML) algorithms are used to train a model and provide insurance costs estimations. Past data is searched for any pattern or trend in the behaviour history of consumers and then future estimations are evaluated. The proposed project is comprised of different regression models like Linear regression with hyperparameterization , regressors like Decision Tree and Random forest to estimate the approximate insurance expenditure. © 2023 IEEE.

Customer's Perspective on Health Insurance Post-Pandemic

India is among the nations most severely impacted by COVID-19, which has affected practically all global industries and sectors, including the insurance sector. The covid pandemic has forced businesses in all industries to alter the way they conduct business, and the health insurance market is no exception. The prolonged lockdown following COVID-19 has forced insurance companies to extensively rely on their digital architecture for everything from selling new policies to customers to handling claims. Many insurance companies create specialised policies to guarantee coverage is not impacted. This essay attempts to explore the effects of COVID-19 on health insurance and how they affect the industry as a whole.

Poverty Reduction Effects of Medical Insurance on Middle-Aged and Elderly Families under the Goal of Common Prosperity in China.

Eliminating poverty due to illness is an important way for China to pursue common prosperity. The high medical expenditure caused by the aging population has brought severe challenges to governments and families of all countries, especially in China, where the entire population has just been lifted out of poverty in 2020 and then hit by COVID-19. How to prevent the possible return of poor boundary families to poverty in China has become a difficult research topic. Based on the latest data from the China Health and Retirement Longitudinal Survey, this paper discusses the poverty reduction effect of medical insurance on middle-aged and elderly families from the absolute index and relative index. Medical insurance had a poverty reduction effect on middle-aged and elderly families, especially the poor boundary families. For example, people who participated in medical insurance reduced their financial burden by 2.36% for middle-aged and older families compared to people who did not participate in medical insurance. Furthermore, the poverty reduction effect had heterogeneity in gender and age. This research brings some policy implications. For example, the government should give more protection to vulnerable groups such as the elderly and low-income families and improve the fairness and effectiveness of the medical insurance system.

Perceptions, Emotions and Motivations of Gig Workers: Insights from Malaysia

The COVID-19 pandemic has changed work arrangements and increased worldwide unemployment. Increasingly, many people have turned to gig work for income. However, low-skilled gig workers, such as food delivery personnel and ride-hailing drivers, are vulnerable to a plethora of disadvantageous working conditions, such as unstable income, lack of medical insurance, and heavy workload. Working remotely outside the workplace has also led to severe loneliness and isolation. Survey results from 100 gig-workers indicated that receiving social support and positive emotion improved job performance and satisfaction. Hence, we propose a peer-mentor supporting system. This paper primarily contributes to improving public awareness about the disadvantageous situations of gig workers. By examining the gig workers' perceptions, emotions, and motivations, this paper contributes to integrating job satisfaction and their inner work-life system. We suggest organizations broadcast gig workers' contributions during the COVID-19 pandemic, which improved their sense of responsibility and intrinsic motivation. © 2022 IEEE.

The Effect of Mobile Payment on Payment Waiting Time for Outpatients With Medical Insurance: Historically Controlled Study.

BACKGROUND: Waiting for a long time to make payments in outpatient wards and long queues of insured patients at the checkout window are common in many hospitals across China. To alleviate the problem of long queues for payment, many hospitals in China have established various mobile apps that those without health insurance can use. However, medically insured outpatients are still required to pay manually at the checkout window. Therefore, it is urgent to use information technology to innovate and optimize the outpatient service process, implement mobile payment for medically insured outpatients, and shorten the waiting time for outpatients, especially in the context of the COVID-19 epidemic. Furthermore, smartphone-based mobile payment for outpatients with health insurance could be superior to on-site cashier billing. OBJECTIVE: This study aimed to investigate the impact of smartphone-based mobile payment in relation to different aspects, such as waiting time, satisfaction with patients' waiting time, payment experience, the proportion of those dissatisfied with payment, total outpatient satisfaction, and outpatient volume, and compare mobile payment with on-site payment. METHODS: This was a historically controlled study. This study analyzed the outpatients' waiting time to make a medical insurance payment, their satisfaction with the waiting time and payment experience, the proportion of those dissatisfied with payment, and the outpatient volume of patients at Guangzhou Women and Children's Medical Center 1 year before and after the implementation of mobile payment for medical insurance in January 2021. An independent sample 2-tailed t test was used to compare waiting time, satisfaction with waiting time, and overall satisfaction. Paired sample 2-tailed t test was used to compare monthly outpatient visits. The chi-square test was used to compare the percentages of patients dissatisfied with payment. RESULTS: After the implementation of mobile payment for medical insurance outpatients, the patients' payment waiting time was significantly shortened (mean 45.28, SD 10.35 min vs mean 1.02, SD 0.25 min; t9014=53.396; P<.001), and satisfaction with waiting time and payment experience were significantly improved (mean 82.08, SD 3.17 vs mean 90.36, SD 3.45; t9014=-118.65; P<.001). Dissatisfaction with payment significantly decreased (10.27%, SD 2.18% vs 1.19% vs SD 0.30%; P<.001). The total satisfaction of outpatients significantly improved (mean 86.91, SD 3.23 vs mean 89.98, SD 3.31; t9014=-44.57; P<.001), and the outpatient volume increased (248,105.58, SD 89,280.76 vs 303,194.75, SD 53,773.12; t11=2.414; P=.03). Furthermore, payment efficiency improved, and the number of the on-site cashiers substantially decreased. CONCLUSIONS: Mobile payment for health insurance significantly shortened patients' payment waiting time; improved patient satisfaction on waiting time and payment experience and overall satisfaction; reduced the proportion of patients who were dissatisfied with payment and the cashier at the hospital; and increased monthly outpatient volume. This approach was effective and thus worthy of promoting.

[The associative approach, a force for progress in a context of Covid-19]. / La démarche associative, force d'avancées dans un contexte de Covid-19.

The pioneering national association "TousPartenairesCovid" dedicated to Covid long has the singularity of operating in 2.0 and cultivating transversality. In two years, it has built up an unprecedented database based on online surveys, worked with the French National Authority for Health and regional health agencies, and designed digital tools including the "Covid long" adult, child and adolescent referral algorithm in partnership with the French National Health Insurance Fund. Very early on, it proposed positioning the coordination support systems- territorial support platforms as post-Covid cells. Today, its flexibility allows it to address other issues, such as facilitating the return to work of patients with long-standing Covid, or modeling care in medical deserts through hybridization between healthcare professionals and emerging e-health tools.

Health Insurers' Response to Current Mental Health Parity Laws

[...]this Note argues that health insurers should take a more meaningful role in complying with and promoting mental health well-being. By the 1980s, any progress made up to that point was soon after undetectable.24 President Bill Clinton later considered mental health parity during his healthcare reform efforts in 1993,25 but these efforts were equally unsuccessful.26 It was only in 1996 that Senators Pete Domenici and John Danforth introduced the first round of momentous federal parity legislation known as The Mental Health Parity Act of 1996 (MHPA).27 Although the MHPA was a compromised version of the more extensive 1992 Domenici-Wellstone bill, it nonetheless was the first of its kind and a sign of things to come.28 According to the MHPA, insurers were prohibited from imposing disparate annual and lifetime limits for mental health benefits when compared to surgical and medical benefits as offered by a group health plan or health insurance issuer offering coverage in connection with a group health plan.29 While this meant that insurers could no longer stymie access to mental health services by providing unequal coverage under a plan, the MHPA contained certain important exceptions. Rather, it only applied to group health plans that offered mental health benefits at the outset, and it did not apply to employers with fewer than 50 employees.30 Moreover, insurers were free to charge different copays and coinsurance rates.31 Lastly, employers could request exempt status from any requirements if they could show a one percent increase in premiums.32 a. The Mental Health Parity and Addiction Equity Act To combat the vast shortcomings of the MHPA,33 Congress eventually passed the Mental Health Parity and Addiction Equity Act in 2008 (MHPAEA).34 This newly enacted law prohibited differences in treatment options as well as certain cost-sharing schemes insurers previously engaged in under the MHPA. [...]according to the MHPA, insurers could set daily limits on outpatient mental health services, set their own coinsurance rates (including co-pays, deductibles, and out-of-pocket maximums), and limit treatment benefits irrespective of any parity considerations.35 Nonetheless, despite these additional requirements, the MHPAEA did not require that health insurers provide coverage for any type of mental health services.36 b. The Affordable Care Act Beyond providing health care for 20 million previously uninsured Americans, the Affordable Care Act (ACA) set the stage for what would become the largest development in access to mental health services this country has ever seen.37 Most notably, the ACA defined "mental health and substance use treatment" as an essential health benefit (EHB)38 and required individual and small-group plans to cover all EHBs.39 As previously noted, the MHPAEA only applied to large employers (50 or more employees) and only if they chose to provide mental health coverage.

Health Insurance Patterns of Older Veterans: Evidence from the Health and Retirement Study

With the increased availability of community care to veterans from the VA MISSION Act, policymakers and providers need to understand how older veterans are insured, particularly before Medicare eligibility at age 65. Using data from 1996 to 2018, this study examines the insurance patterns of veterans prior to the expansion of access to community care through the VA and compares those patterns to nonveterans. This study finds that veterans are more likely to have insurance than nonveterans and that they are less likely to rely on Medicaid and Medicare before age 65. Regression estimates also suggest that veterans with at least some college education are less likely to have private insurance and are more likely to be uninsured than nonveterans with the same educational attainment.

Immigrants' health education and economic behaviours: saving rates, social medical insurance and house purchase

Healthy China is a crucial policy for advancing global health, addressing inequality between rural and urban health education, and helping the domestic markets recover after the COVID-19 outbreak. This study combines life cycle mechanisms and safety beliefs to evaluate the long-lasting values of health education. We employed data from the China Migration Dynamic Surveys to examine the economic behaviours of 720,900 immigrants using a robust empirical approach combining an Extended Regression Model (E.R.M.), Average Treatment Effects (A.T.E.), and heterogeneous treatment effects. We find that health education increases participation in social medical insurance and the likelihood of purchasing a house. In contrast, the relationship between health education and saving rates is non-linear effects. Empirically robust heterogeneous treatment effects account for heterogeneity in the previous and the younger generations, as well as urban and rural citizens' long-run effects of health education. This study's findings suggest that health education stimulates immigrants' consumption behaviours;however, extra health education is not desirable. Rural-urban citizenship acquisition bias is found to significantly affect health education.

Measuring the efficiency of the healthcare sector in Poland – a window-DEA evaluation

Purpose>The main aim of the study was to measure and assess the efficiency of the healthcare system in Poland.Design/methodology/approach>An output-oriented Data Envelopment Analysis model with a 2-years window analysis extension was used between 2013 and 2018. The analysis was completed with a determination of the sources of productivity changes (between the first and last year of the study period) and factors that influence efficiency.Findings>Efficient regions have been identified and the spatial diversity in their efficiency was confirmed. The study identified individual efficiency trends together with “all-windows” best and worst performers. Using panel modeling, it was confirmed that the efficiency of health protection is influenced by, among others, accreditation certificates, the length of the waiting list or the number of medical personnel.Research limitations/implications>Although the analysis was conducted at the voivodeship level (NUTS2), which was fully justified, it would be equally important to analyze data with a lower aggregation level. It would be extremely valuable from the perspective of difficulties faced by the healthcare system in Poland.Practical implications>The identification of areas and problems affecting the efficiency of the healthcare system in Poland may also be a hint for other countries with similar system solutions that also struggle with the same problems.Originality/value>The paper explains the efficiency of the country's healthcare system while also paying attention to changes in its level, factors influencing it, spatial diversity and impact on the sector functioning.

Person-environment fit: a luxury good for those who can afford it?

Purpose>The study integrates organizational demography theory into person-environment fit theories to question the assumption that all employees can afford to strive for person-environment fit. The ethnic/racial diversity in organizations is investigated as a boundary condition in order to develop implications to mitigate the challenges of employees with precarious jobs, especially persons of color (POCs), in the society.Design/methodology/approach>Publicly accessible and objective data from organizations in the S&P 1500 index were collected through Compustat, ExecuComp, the Bloomberg Terminal and the websites of Fortune, the United States Census Bureau and the U.S. Department of Labor. A path analysis of time-lagged data was performed to support causal relationships between the examined constructs while controlling for alternative explanations.Findings>Unsafe working conditions moderate the U-shaped relationship between ethnic/racial diversity and turnover and turn it into an inverted U-shaped relationship because employees in precarious jobs, especially POCs, cannot afford to leave unsafe working conditions. Organizations with unsafe working conditions are more likely to invest in sustainability initiatives. However, organizations' financial performance does not benefit from this investment.Originality/value>The circumstance that not all employees can afford person-environment fit and its organizational outcomes are identified and empirically tested. Scholars can integrate this boundary condition in future research. Implications for practice and policy are also derived.

U.S. Household Financial Vulnerability: Prediction Analyses in the COVID-19 Pandemic

In this article, we projected household financial vulnerability in the COVID-19 pandemic. Using a nationally representative sample of households from the 2017 Panel Study of Income Dynamics (PSID), we analyzed potential changes in financial status in the pandemic resulting from loss of income and savings from discretionary consumption. We provided a ranking of household groups by their financial vulnerability and the first estimate of the number of households at various degrees of financial vulnerability. Our study showed that a substantial part of the universal stimulus payments was made to households that had sufficient income to cover basic needs and those saved by reducing discretionary expenses. For the most financially vulnerable, the first one-time stimulus payment was too little and too late to help with their financial difficulties. Our findings shed light on to whom and in what form the US government should direct financial assistance during the pandemic.

The Relationship Between the Health Services Price Index and The Real Effective Exchange Rate Index in Turkey: A Frequency Domain Causality Analysis

This paper examines whether the causal relationship between the health care price index and the real exchange rate index is temporary or permanent. To do this, we first apply the Toda- Yamamoto causality test with a structural break and then continue with frequency domain causality tests based on the Toda-Yamamoto causality test with a structural break. The results of the Toda- Yamamoto causality test with a structural break indicates that there is causality running from the real exchange rate index to the health care price index. Moreover, the frequency domain causality test results based on the Toda-Yamamoto causality test with a structural break provide evidence that the real effective exchange rate causes temporarily (in the short-and medium term) to the health care price index. The effect of the real exchange rate index on the health care price index lasts between 2 months and 8.37 months. These findings imply that there is a significant exchange rate pass-through in health care inflation in the short-and medium term. Thus, the health authorities should take into account these findings when planning health care policies in Turkey, especially health care services heavily dependent on imported materials.

Can We Increase Health Expenditure Per Capita Through Higher Economic Growth? Empirical Evidence from Turkey

Many researchers indicate that health expenditures positively contribute to economic growth and prosperity, emphasizing that when healthy individuals are more efficient, they make a huge contribution to human capital, which in turn improves productivity. There is also a relationship between economic growth and health expenditures, meaning that health expenditure is a function of income and higher income leads to an increase in spending on health. In this study, we assess whether economic growth has an impact on healthcare expenditure by focusing on an emerging market economy. Therefore, the main objective of this paper is to test the impact of economic performance on health expenditure per capita for Turkey in the period of 1999-2018. In the analysis, the unit root properties are tested by using RALS (Residual Augmented Least Squares) ADF and traditional Augmented Dickey Fuller (ADF) unit root tests. In order to examine the long-run relationship between economic growth and health expenditure per capita, we employ the RALS Engle-Granger and traditional Engle-Granger cointegration tests. The findings of our analysis support the evidence of a long-run impact of economic growth on healthcare expenditure per capita for Turkey in the relevant period.Alternate :Birçok iktisatçı, sağlıklı bireylerin verimliliği artırdığını vurgulayarak, sağlık sistemine yapılan yatırımların ekonomik büyümeye olumlu katkıda bulunduğuna işaret etmektedir. Benzer şekilde, sağlık harcamaları gelirin bir fonksiyonudur;gelir arttıkça sağlık harcamaları artmaktadır. Bu çalışmada, temel olarak, gelişmekte olan bir ülkede, ekonomik büyümenin sağlık harcamaları üzerinde etkisi olup olmadığı sorusu cevaplanmaya çalışılmaktadır. Dolayısıyla, bu çalışmanın amacı, Türkiye'de, ekonomik büyüme ile kişi başına düşen sağlık harcamaları arasındaki ilişkinin 1999-2018 dönemi için analiz edilmesidir. Analizde, serilerin durağanlığının test edilmesi amacıyla, geleneksel ADF testine ek olarak, RALS (Residual Augmented Least Squares) ADF birim kök testi uygulanmaktadır. Ekonomik büyüme ve kişi başına sağlık harcamaları arasındaki uzun dönemli ilişkinin test edilmesi amacıyla ise, Engle-Granger ve RALS Engle-Granger kointegrasyon testlerinden yararlanılmaktadır. Analiz sonuçları, ekonomik büyümenin kişi başına düşen sağlık harcamaları üzerinde uzun dönemde etkisi olduğuna işaret etmektedir.

Emotional branding, corporate image and its effect on the loyalty of JKN-KIS participants: A mediating role of satisfaction

Health as a basic necessity of life, the ownership of health insurance is very important and very influential in ensuring a safe and secure life. The National Health Insurance as part of the National Social Security System aims to meet the basic health needs of the Indonesian people. This study aims to analyze the role of satisfaction in mediating the influence of emotional branding and corporate image on customer loyalty. Independent participants of JKN-KIS BPJS Health Malang Branch as the sampling in this study. The sampling technique used purposive sampling with a sample of 130 respondents. Data analysis in this study used Structural Equation Modeling-Partial Least Square (SEM-PLS). The results of the study concluded that emotional branding affects loyalty and satisfaction;the corporate image has an effect on loyalty and satisfaction;satisfaction affects loyalty;satisfaction mediates the effect of emotional branding and corporate image on loyalty. Satisfaction acts as a partial mediating variable.

Consumers’ decision-making self-efficacy for service purchases: construct conceptualization and scale

Purpose>The purpose of this study is to develop and validate a scale to determine the consumer’s level of decision-making self-efficacy for a high-involved service purchase, specifically the purchase of medical insurance. One question to ask is how service providers can help consumers purchase the services that best meet their needs? Before interventions can occur, it is necessary to benchmark consumers’ perceptions of their own decision-making control and abilities.Design/methodology/approach>A scale that measures consumers’ service decision-making self-efficacy was developed using the principles established for scale development validation. A four-study approach was used to reach the research objective.Findings>The research consisted of four studies designed to: generate items to measure consumer service decision-making self-efficacy (CSDMSE);purify the scale and assess its dimensionality (second-order structure);establish the reliability and validity of the scale;and establish norms to provide details on its usefulness for aiding consumers with service purchases. The scale was found to be a higher-order construct, comprising three lower-order constructs.Originality/value>Research suggests that consumer self-efficacy may affect their decision-making. The greater the consumer’s self-efficacy for decision-making tasks, the more efficient the decision-making process strategies are expected to be. This is the purpose for which the CSDMSE scale measure was created: to understand how, where and when service professionals can assist consumers with making appropriate service-related decisions and purchases.

End-to-End Encryption and Prediction of Medical Insurance Cost

Health-care costs are rising on a daily basis after the advent of Covid. Most importantly, health issues are becoming more prevalent and critical. As a result, predicting medical insurance cost has become unavoidable as many people choose insurance. However, for a secure system, the entire prediction model for each customer should be encrypted end-to-end. To create a better prediction model, Machine learning regression algorithms are used. The prediction model will be encrypted end-to-end. This paper will give the steps of developing a reliable medical insurance cost prediction model. © 2022 IEEE.

Assessing the responsiveness of out-of-pocket healthcare expenditure to macro-fiscal factors and different health financing systems: evidence from the European and OECD area

Purpose>In this paper, the authors assess the responsiveness of OOP healthcare expenditure to macro-fiscal factors, as well as to tax-based, SHI, mixed systems and voluntary PHI financing. Although the relationship between OOP expenditure, macroeconomy, aggregate public and PHI financing is well documented in the existing empirical literature, little is known for the impact of several macro-fiscal drivers and the existing health financing arrangements associated with voluntary PHI on OOP expenditure.Design/methodology/approach>The authors gather panel data by applying three official organizations’ databases. They elaborate static and dynamic panel data methodology to a dataset of 49 European and OECD countries from 2000 to 2015.Findings>The authors’ findings do not indicate a considerable impact of GDP growth and general government debt as a share of GDP on OOP payments. Unemployment rate presents as a positive driver of OOP payments in all three compulsory national health systems post to the 2008 economic crisis. OOP payments are significantly influenced by countries’ fiscal capacity to increase general government expenditure to GDP in SHI and mixed health systems. Additionally, study findings present that government health financing, irrespective of the different health systems structure characteristics, and OOP healthcare payments follow different directions. Voluntary PHI financing considerably counteracts OOP payments only in tax-based health systems.Practical implications>In the backdrop of a new economic crisis associated to the COVID-19 epidemic, health policy planners have to deal with the emerging unprecedented challenges in financing of health systems, especially for these economies that have to face the fiscal capacity constraints owing to the 2008 financial crisis and its severe recession.Originality/value>To the best of authors’ knowledge, there is no empirical consensus on the effects of macro-fiscal parameters, different compulsory health systems financing associated with the parallel voluntary PHI institution funding on OOP expenditure, for the majority of European and OECD settings.

Special Issue “Quantitative Risk Assessment in Life, Health and Pension Insurance”

The high volatility in financial markets, together with the ultra-low interest rates environment and the increased expectation of life, constitute serious threats for providers of long-term investment guarantees and lifelong benefits. To this end, a stochastic model for traditional life insurance contracts is proposed and framed within the Solvency II Directive. The paper ends with the presentation of a case study of a portfolio of life insurance contracts, which testifies the effectiveness of the model in highlighting the main drivers of capital requirement evaluation.