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Personalized medicine is still in its infancy, with costly genetic tests providing little actionable information in terms of efficient prevention decisions. As a consequence, few people undertake these tests currently, and health insurance contracts pool all agents irrespective of their genetic background. Cheaper and especially more informative tests will induce more people to undertake these tests and will impact not only the pricing but also the type of health insurance contracts. We develop a setting with endogenous prevention decisions and we study which contract type (pooling or separating) emerges at equilibrium as a function of the proportion of agents undertaking the genetic test as well as of the informativeness of this test. Starting from the current low take-up rate generating at equilibrium a pooling contract with no prevention effort, we obtain that an increase in the take-up rate has first an ambiguous impact on welfare, and then unambiguously decreases welfare as one moves from a pooling to a separating equilibrium. It is only once the take-up rate is large enough that the equilibrium is separating that any further increase in take-up rate increases aggregate welfare, by a composition effect. However, a better pooling contract in which policyholders undertake preventive actions (and lower their health risk) can also be attained if the informativeness of the genetic tests increases sufficiently.

We develop a model where a free genetic test reveals whether the individual tested has a low or high probability of developing a disease. A costly prevention effort allows high-risk agents to decrease the probability of developing the disease. Agents are not obliged to take the test, but must disclose its results to insurers. Insurers offer separating contracts which take into account the individual risk, so that taking the test is associated to a discrimination risk. We study the individual decisions to take the test and to undertake the prevention effort as a function of the effort cost and of its e¢ ciency. We obtain that, if effort is observable by insurers, agents undertake the test only if the effort cost is neither too large nor too low. If the effort cost is not observable by insurers, they face a moral hazard problem which induces them to under-provide insurance. We obtain the counterintuitive result that moral hazard increases the value of the test if the effort cost is low enough. Also, agents may perform the test for lower levels of prevention e¢ ciency when effort is not observable

We analyze whether the introduction or an increase of unemployment insurance (UI hereafter) beneÖts in developing countries reduces the e§ort made by unemployed workers to secure a new job in the formal sector. We adopt a comparative static approach and we consider the consequences of an increase of current UI beneÖts on unemployed workersídecision variables in this same period, i.e. we focus on an intra-temporal trade-o§, allowing us to assume away moral hazard complications. When there is no informal sector, unemployed workers may devote their time between e§ort to secure a new job in the formal sector and leisure. In the presence of an informal sector, unemployed workers may also devote time to remunerated informal activities. Consequently, the amount of e§ort devoted to secure a new (formal) job generates an opportunity cost, which ceteris paribus, reduces the amount of time devoted to remunerated activities in the informal sector. We show that in the presence of an informal sector, an increase of current UI beneÖts decreases this marginal opportunity cost and therefore unambiguously increases the e§ort undertaken to secure a new job in the formal sector. This intra-temporal e§ect is the only one at play in presence of one-shot UI beneÖts or with severance payments mechanism.

This paper uses a two-sided market model of hospital competition to study the implications of di§erent remunerations schemes on the physiciansí side. The two-sided market approach is characterized by the concept of common network externality (CNE) introduced by Bardey et al. (2010). This type of externality occurs when occurs when both sides value, possibly with di§erent intensities, the same network externality. We explicitly introduce e§ort exerted by doctors. By increasing the number of medical acts (which involves a costly e§ort) the doctor can increase the quality of service o§ered to patients (over and above the level implied by the CNE). We Örst consider pure salary, capitation or fee-for-service schemes. Then, we study schemes that mix fee-for-service with either salary or capitation payments. We show that salary schemes (either pure or in combination with fee-for-service) are more patient friendly than (pure or mixed) capitations schemes. This comparison is exactly reversed on the providersíside. Quite surprisingly, patients always loose when a fee-for-service scheme is introduced (pure of mixed). This is true even though the fee-for-service is the only way to induce the providers to exert e§ort and it holds whatever the patientsívaluation of this e§ort. In other words, the increase in quality brought about by the fee-for-service is more than compensated by the increase in fees faced by patients.

We evaluate the impact of a price cap regulation implemented in the Colombian pharmaceutical market between 2011 and 2014. To do so, we take advantage of a unique data set where we observe three sources of variation: i) differences across eighteen groups in the Anatomical Therapeutic Chemical (ATC) classification system of the WHO, ii) the existence of regulated treated) and unregulated (control) groups within each of these eighteen ATC groups, and iii) differences in time (before and after regulation) for the eighteen ATC groups. A triple dierences model with fixed time effects and cluster errors is used to identify the impact of this regulation. We find that the price-cap regulation contributed to reduce prices in three of the eighteen groups and increase average prices for ten of them. We confirm then that the focal point effect generated by a price-cap regulation can generate unintended distortions. More specifically, our results reveal that the implementation of this price cap regulation potentially increased -public and ;private- expenditure by 30%, only for the 2,422 drugs in the eighteen ATC groups we study.

Using detailed daily information covering 100 countries and an event-study approach, we estimate the short run eects of implementing Non-Pharmaceutical Interventions (NPIs) on the spread of the COVID-19 virus at the early stages of the pandemic. We study the impact of two NPIs {stay-at-home requirements and workplace closures{ on three outcomes: daily residential and workplace mobility; the daily growth rate of cases; and the daily growth rate of fatalities. We find that immediately after NPIs were implemented, mobility declined by 0.2 standard deviation (SD), and two weeks afterwards it was down by 0.7 SDs. 25 days after the NPIs were implemented, the daily growth rate of cases and deaths was lower by 10% and 8.4% respectively. Our results reveal that between 53 and 72 percent of the reduction of the daily growth rate of cases and deaths associated with a reduction of mobility is caused by NPIs.

International audience

International audience

International audience

International audience

International audience

International audience

International audience