An empirical examination of risk equalisation in a regulated community rated health insurance market

Despite universal access entitlements to the public healthcare system in Ireland, over half the population is covered by voluntary private health insurance. The market operates on the basis of community rating, open enrolment and lifetime cover. A set of minimum benefits also exists, and two risk equalisation schemes have been put in place but neither was implemented. These schemes have proved highly controversial. To date, the debate has primarily consisted of qualitative arguments. This study adds a quantitative element by analysing a number of pertinent issues. A model of a community rated insurance market is developed, which shows that community rating can only be maintained in a competitive market if all insurers in the market have the same risk profile as the market overall. This has relevance to the Irish market in the aftermath of a Supreme Court decision to set aside risk equalisation. Two reasons why insurers’ risk profiles might differ are adverse selection and risk selection. Evidence is found of the existence of both forms of selection in the Irish market. A move from single rate community rating to lifetime community rating in Australia had significant consequences for take-up rates and the age profile of the insured population. A similar move has been proposed in Ireland. It is found that, although this might improve the stability of community rating in the short term, it would not negate the need for risk equalisation. If community rating were to collapse then risk rating might result. A comparison of the Irish, Australian and UK health insurance markets suggests that community rating encourages higher take-up among older consumers than risk rating. Analysis of Irish hospital discharge figures suggests that this yields significant savings for the Irish public healthcare system. This thesis has implications for government policy towards private health insurance in Ireland.

Risk management and the potential of cattle insurance in Tigray, Northern Ethiopia

This study explores the role of livestock insurance to complement existing risk management strategies adopted by smallholder farmers. Using survey data, first, it provides insights into farmers’ risk perception of livestock farming, in terms of likelihood and severity of risk, attitude to risk and their determinants. Second, it examines farmers’ risk management strategies and their determinants. Third, it investigates farmers’ potential engagement with a hypothetical cattle insurance decision and their intensity of participation. Factor analysis is used to analyse risk sources and risk management, multiple regressions are used to identify the determinants; a Heckman model was used to investigate cattle insurance participation and intensity of participation. The findings show different groups of farmers display different risk attitude in their decision-making related to livestock farming. Production risk (especially livestock diseases) was perceived as the most likely and severe source of risk. Disease control was perceived as the best strategy to manage risk overall. Disease control and feed management were important strategies to mitigate the production risks. Disease control and participation on safety net program were found to be important to counter households’ financial risks. With regard to the hypothetical cattle insurance scheme, 94.38% of households were interested to participate in cattle insurance. Of those households that accepted cattle insurance, 77.38% of the households were willing to pay the benchmark annual premium of 4% of the animal value while for the remaining households this was not affordable. The average number of cattle that farmers were willing to insure was 2.71 at this benchmark. Results revealed that income (log income) and education levels influenced positively and significantly farmers’ participation in cattle insurance and the number of cattle to insure. The findings prompt policy makers to consider livestock insurance as a complement to existing risk management strategies to reduce poverty in the long-run.

How Does the Unemployment Insurance System Shape the Time Profile of Jobless Duration?

This paper updates a sparse literature on the effects of unemployment benefits (UB) on the time profile of escape rates from unemployment. These effects, as well as those of other regressors, are found to vary profoundly over the course of unemployment.

Isotope Hydrology of the Oldman River basin, southern Alberta, Canada

The partially semi-arid Oldman River basin (OMRB), located in southern Alberta (Canada), has an area of 28 200 km2, is forested in its western headwater part, and is used for agriculture in its eastern part. Hydrometric measurements indicate that flow in the Oldman River has decreased by ~34% between 1913 and 2003, and it is predicted that water withdrawals will increase in the next 20 years. The objective of this study was to determine whether isotope ratio measurements can provide further insight into the water dynamics of the Oldman River and its tributaries. Surface water samples were collected monthly between December 2000 and March 2003. Groundwater samples were taken from 58 wells during one-time sampling trips. Runoff within the OMRB is currently about 70 mm year-1, with a corresponding runoff ratio of 0Ð18. Seasonal flow characteristics are markedly different upstream and downstream of the Oldman River reservoir. Upstream, sharp increases in flow in late spring and early summer are followed by a rapid decrease to base flow levels. Downstream, a prolonged high flow peak is observed due to the storage effect of the Oldman River reservoir. The seasonal variation in the isotopic composition of surface water from upstream sites is small. This suggests that peak runoff is not predominantly generated by melting snow accumulated during the preceding winter, but mainly by relatively well-mixed young groundwater. A significant increase in the d18O and d2H values in the downstream part of the basin was observed. The increase in the isotopic values is partly due to surface water and groundwater influx with progressively higher d18O and d2H values in the eastern part, and partly due to evaporation. Hence, the combination of hydrometric data with isotope measurements yields valuable insights into the water dynamics in the OMRB that may be further refined with more intensive measurement programmes in the future.

Nitrogen budget for the Oldman River Basin, southern Alberta, Canada

The Oldman River Basin (OMRB), located in southern Alberta (Canada), with an area of 28,200 km2, is mainly forested in its western part and is used for intensive agriculture in its eastern part. The objective of this paper is to estimate the nitrogen (N) budget for the Oldman River Basin as a whole and its sub-basins, and to discuss differences in the N budget between various sub-basins. Better knowledge of the N budget in this watershed may be also utilized for understanding N dynamics in similar watersheds within semi-arid climatic regions. The model used is a mass balance spreadsheet model that takes into account N inputs and N export through surface water. During the last 120 years, anthropogenic N inputs to the OMRB have increased circa 40 fold. By the end of the 20th century, the OMRB received an annualN input of about 5174 kg N km-2 yr-1, whereas only about 25 kg N km-2 yr-1 were exported via riverine flow. For the sub-basins, annual N inputs ranged from 2516 to 19011 kg N km-2 yr-1, and annual N export via riverine flows varied between 6 and 277 kg N km-2 yr-1. Over 85% of total N inputs to the OMRB are due to anthropogenic activities, including manure (55%), synthetic fertilizer (27%), and N fixation on agricultural lands (4%). Sewage accounted for less than 1%, and N inputs from atmospheric deposition and fixation in forests represented 6 and 8% respectively. Despite increasing anthropogenic N inputs, N export with riverine flow currently accounts for only 1% of the inputs, indicating thatmost of theNinputs are currently retained in the OMRB or are re-emitted into the atmosphere.

Isotopic Assessment of Sources of Surface Water Nitrate within the Oldman River Basin, Southern Alberta, Canada

Concentrations and isotopic compositions of NO-3 from the Oldman River (OMR) and some of its tributaries (Alberta, Canada) have been determined on a monthly basis since December 2000 to assess temporal and spatial variations of riverine NO-3 sources within the OMR basin. For the OMR sites, NO-3 -N concentrations reached up to 0.34 mg L-1, d15N-NO-3 values varied between –0.3 and +13.8‰, and d18O-NO-3 values ranged from –10.0 to +5.7‰. For the tributary sites, NO-3 -N concentrations were as high as 8.81 mg L-1, d15N-NO-3 values varied between –2.5 and +23.4‰, and d18O-NO-3 values ranged from –15.2 to +3.4‰. Tributaries in the western, relatively pristine forested part of the watershed add predominantly NO-3 to the OMR with d15N-NO-3 indicative of soil nitrification. In contrast, tributaries in the eastern agriculturally-urban-industrially-used part of the basin contribute NO-3 with d15N-NO-3 values of about +16‰ indicative of manure and/or sewage derived NO-3. This difference in d15N-NO-3 values of tributaries was found to be independent of the season, but rather indicates a spatial change in the NO-3 source, which correlates with land use changes within the OMR basin. As a consequence of tributary influx, d15N-NO-3 values in the Oldman River increased from +6‰ in the downstream direction (W to E), although [NO-3 -N] increased only moderately (generally