The law of group insurance,

"Text-writers and periodicals cited": p. x

Lifetime cover in private insurance markets

In the last few decades, private health insurance rates have declined in many countries. In countries and states with community rating, a major cause is adverse selection. In order to address age-based adverse selection, Australia has recently begun a novel approach which imposes stiff penalties for buying private insurance later in life, when expected costs are higher. In this paper, we analyze Australiarsquos Lifetime Cover in the context of a modified version of the Rothschild-Stiglitz insurance model (Rothschild and Stiglitz, 1976). We allow empirically-based probabilities to increase by age for low-risk types. The model highlights the shortcomings of the Australian plan. Based on empirically-based probabilities of illness, we predict that Lifetime Cover will not arrest adverse selection. The model has many policy implications for government regulation encouraging long-term health coverage.

Parametrikus nyugdíjreformok és életciklus-munkakínálat (Parametric pension reforms and life-cycle labour supply)

A társadalombiztosítási nyugdíjrendszer finanszírozása pusztán a demográfiai folyamatok következtében is jelentős terhet ró majd a költségvetésére, amin a különböző parametrikus és paradigmatikus nyugdíjreformok enyhíthetnek. A reformok azonban hosszú távon olyan viselkedési, munkakínálati reakciókat válthatnak ki, amelyek alapvetően változtatják meg a költségvetési hatásokat. Az 1999 és 2009 között Magyarországon megfigyelhető átlagos munka- és nyugdíjkorprofilok bemutatása után arra tettünk kísérletet, hogy mikroökonómiai alapon határozzuk meg néhány alapvető parametrikus nyugdíjreformnak a férfiak életciklus-munkakínálatára gyakorolt hatását. A modell paramétereit a magyar gazdaság 1999 és 2009 közötti jellemzőinek megfelelően kalibráltuk. Eredményeink szerint a helyettesítési ráta csökkentése, a nyugdíjkorhatár emelése és a svájci indexálás árindexálásra cserélése összességében számottevően növeli az egyes képzettségi csoportok munkakínálatát, s a fiatalabb korosztályok javára csoportosítja át az életciklus-munkakínálatot, míg a nyugdíj kiszámításához figyelembe vett évek számának megváltoztatása nem hoz jelentős aggregált hatást, és nem jár a munkakínálat korcsoportok közötti átcsoportosításával. ____ Financing the social-security pension system will weigh heavily on the government budget in developed countries, merely through the projected demographic processes. The burden could be eased by various parametric and paradigmatic pension reforms, but in the long run such reforms may trigger behavioural, labour-supply responses, which may alter the budgetary effects fundamentally. Having described the average work and pension profiles in Hungary between 1999 and 2009, the authors use a microeconomic approach in an attempt to assess the effect of certain parametric pension reforms on the life-cycle labour supply of males. The parameters for the model were calibrated for the characteristics of the Hungarian economy. The results show that decreasing the replacement rate, increasing the retirement age and replacing Swiss indexation of pensions by price indexation cause a considerable increase in the labour supply of all education-level groups, whereas changing the number of years considered in computing pensions does not have a significant aggregate effect. While introducing price indexation increases the labour supply of all cohorts by the same amount, the other reforms reallocate the life-cycle labour supply, mainly towards younger age-groups.

Quality of life and application of the transtheoretical model to diabetes self -management behaviors in older adults with type 2 diabetes

One in five adults 65 years and older has diabetes. Coping with diabetes is a lifelong task, and much of the responsibility for managing the disease falls upon the individual. Reports of non-adherence to recommended treatments are high. Understanding the additive impact of diabetes on quality of life issues is important. The purpose of this study was to investigate the quality of life and diabetes self-management behaviors in ethnically diverse older adults with type 2 diabetes. The SF-12v2 was used to measure physical and mental health quality of life. Scores were compared to general, age sub-groups, and diabetes-specific norms. The Transtheoretical Model (TTM) was applied to assess perceived versus actual behavior for three diabetes self-management tasks: dietary management, medication management, and blood glucose self-monitoring. Dietary intake and hemoglobin A1c values were measured as outcome variables. Utilizing a cross-sectional research design, participants were recruited from Elderly Nutrition Program congregate meal sites (n = 148, mean age 75). ^ Results showed that mean scores of the SF-12v2 were significantly lower in the study sample than the general norms for physical health (p < .001), mental health (p < .01), age sub-group norms (p < .05), and diabetes-specific norms for physical health (p < .001). A multiple regression analysis found that adherence to an exercise plan was significantly associated with better physical health (p < .001). Transtheoretical Model multiple regression analyses explained 68% of the variance for % Kcal from fat, 41% for fiber, 70% for % Kcal from carbohydrate, and 7% for hemoglobin A 1c values. Significant associations were found between TTM stage of change and dietary fiber intake (p < .01). Other significant associations related to diet included gender (p < .01), ethnicity (p < .05), employment (p < .05), type of insurance (p < .05), adherence to an exercise plan (p < .05), number of doctor visits/year ( p < .01), and physical health (p < .05). Significant associations were found between hemoglobin A1c values and age ( p < .05), being non-Hispanic Black (p < .01), income (p < .01), and eye problems (p < .05). ^ The study highlights the importance of the beneficial effects of exercise on quality of life issues. Furthermore, application of the Transtheoretical Model in conjunction with an assessment of dietary intake may be valuable in helping individuals make lifestyle changes. ^

146th Annual Report of the Insurance Division, August 2016

Annual report on the insurance industry. Statistical tables reflect in detail the financial condition of all insurance companies licensed to do business in Iowa, based on their sworn annual statements covering the twelve-month period beginning January 1, 2015, and ending December 31, 2015, filed with the Division.

145th Annual Report of the Insurance Division, August 2015

Annual report on the insurance industry. Preliminary material outlines Insurance Division activities generally. The statistical tables reflect in detail the financial condition of all insurance companies licensed to do business in Iowa, based on their sworn annual statements covering the twelve-month period beginning January 1, 2014, and ending December 31, 2014, filed with the Division.

Life-cycle portfolio choice with liquid and illiquid financial assets

Traditionally, quantitative models that have studied households׳ portfolio choices have focused exclusively on the different risk properties of alternative financial assets. We introduce differences in liquidity across assets in the standard life-cycle model of portfolio choice. More precisely, in our model, stocks are subject to transaction costs, as considered in recent macroliterature. We show that when these costs are calibrated to match the observed infrequency of households׳ trading, the model is able to generate patterns of portfolio stock allocation over age and wealth that are constant or moderately increasing, thus more in line with the existing empirical evidence.

The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and its Association with Quality of Life in Ambulatory Patients Receiving Radiotherapy

OBJECTIVE: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). DESIGN: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. SETTING: Australian radiation oncology facilities. SUBJECTS: Sixty cancer patients aged 24-85 y. INTERVENTION: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). RESULTS: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=-0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=-0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001). CONCLUSION: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.