TY  - JOUR
AU  - Oster,Emily
AU  - Shoulson,Ira
AU  - Quaid,Kimberly
AU  - Dorsey,E. Ray
TI  - Genetic Adverse Selection: Evidence from Long-Term Care Insurance and Huntington Disease
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 15326
PY  - 2009
Y2  - September 2009
UR  - http://www.nber.org/papers/w15326
L1  - http://www.nber.org/papers/w15326.pdf
N1  - Author contact info:
Emily Oster
University of Chicago
Booth School of Business
5807 South Woodlawn Ave
Chicago, IL 60637
Tel: 773/834-1552
Fax: 773-834-8172
E-Mail: eoster@uchicago.edu

Ira Shoulson
University of Rochester
School of Medicine and Dentistry
Department of Neurology
601 Elmwood Ave, Box 673
Rochester, New York 14642
E-Mail: Ira.Shoulson@ctcc.rochester.edu

Kimberly Quaid
IUPUI
E-Mail: kquaid@iupui.edu

E. Ray Dorsey
Johns Hopkins University
Department of Neurology
Meyer Bldg, Room 6-181
600 N. Wolfe Street
Baltimore, MD  21287
E-Mail: Ray.Dorsey@jhmi.edu
AB  - Individual, personalized genetic information is increasingly available, leading to the possibility of greater adverse selection over time, particularly in individual-payer insurance markets; this selection could impact the viability of these 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. We use these estimates to make predictions about the future of this market as genetic information increases.  We argue that even relatively limited increases in genetic information may threaten the viability of private long-term care insurance.
ER  -