The Experts below are selected from a list of 3825 Experts worldwide ranked by ideXlab platform
Karine Lamiraud - One of the best experts on this subject based on the ideXlab platform.
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Switching costs in competitive health Insurance markets : the role of insurer's pricing strategies
2020Co-Authors: Karine Lamiraud, Pierre StadelmannAbstract:Our article deals with pricing strategies in Swiss health Insurance markets and focuses on the relationship between basic and Supplementary Insurance. We analyzed how firms’ pricing strategies (i.e., pricing of basic and Supplementary products) can create switching costs in basic health Insurance markets, thereby preventing competition in basic Insurance from working properly. More specifically, using unique market and survey data, we investigated whether firms use bundling strategies or Supplementary products as low-price products to attract and retain basic Insurance consumers. To our knowledge, this is the first paper to analyze these pricing strategies in the context of Insurance/health Insurance. We found no evidence of bundling in the Swiss setting. We did however observe that firms used low-price Supplementary products that contributed to lock in consumers. A majority of firms offered at least one of such product at a low price. None offered low-price products in both basic and Supplementary markets. Low-price Insurance products differed across firms. When buying a lowprice Supplementary product, consumers always bought their basic contract from the same firm. Furthermore, those who opted for low-price Supplementary products were less likely to declare an intention to switch basic Insurance firms in the near future. This result was true for all risk category levels.
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Assurance maladie en Suisse: l'assurance supplémentaire nuit-elle à la concurrence sur l'assurance de base ?
2013Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:Many countries have introduced competition in health Insurance markets. Managed competition settings have been implemented in order to avoid risk selection problems. In Germany, the Netherlands, Switzerland and Israel citizens can choose between different providers for basic coverage. In this article, we focus on the specific case of Switzerland which implemented managed competition in basic health Insurance markets in 1996. We study to what extent consumer choice for one's basic health plan may interact with the decision to subscribe to Supplementary Insurance. The organization of social health Insurance in France is currently very different from the Swiss system. However the question of regulating complementary health care Insurance markets in France may be discussed in the middle/long run using the Swiss model. In Switzerland, competition in basic health Insurance markets has not been effective so far. There is no evidence of premium convergence within cantons. Consumers have been reluctant to switch to less expensive funds. We investigate one possible barrier to switching behavior, namely the influence of Supplementary Insurance. We show that low switching rates are the result of the existence of two health Insurance markets which are regulated differently: the basic health Insurance market where risk selection is prohibited and the Supplementary health Insurance market where risk selection practices are allowed. We show that holding a Supplementary contract reduces the probability of switching basic Insurance provider for those with poor self-assessed health but has no effect on the switching behavior of enrollees in good/very good health. The efficient management of competition in the basic Insurance market may suffer from a lack of adequate regulation in the Supplementary market.
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The influence of Supplementary health Insurance on switching behaviour: evidence from Swiss data
Health Economics, 2009Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:his paper focuses on the switching behaviour of enrolees in the Swiss basic health Insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers in basic Insurance, there is limited evidence of premium convergence within cantons. This indicates that competition has not been effective so far, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of Supplementary Insurance. We use survey data on health plan choice (a sample of 1943 individuals whose switching behaviours were observed between 1997 and 2000) as well as administrative data relative to all Insurance companies that operated in the 26 Swiss cantons between 1996 and 2005. The decision to switch and the decision to subscribe to a Supplementary contract are jointly estimated. Our findings show that holding a Supplementary Insurance contract substantially decreases the propensity to switch. However, there is no negative impact of Supplementary Insurance on switching when the individual assesses his/her health as 'very good'. Our results give empirical support to one possible mechanism through which Supplementary Insurance might influence switching decisions: given that subscribing to basic and Supplementary contracts with two different insurers may induce some administrative costs for the subscriber, holding Supplementary Insurance acts as a barrier to switch if customers who consider themselves 'bad risks' also believe that insurers reject applications for Supplementary Insurance on these grounds. In comparison with previous research, our main contribution is to offer a possible explanation for consumer inertia. Our analysis illustrates how consumer choice for one's basic health plan interacts with the decision to subscribe to Supplementary Insurance.
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The influence of Supplementary health Insurance on switching behaviour: evidence on Swiss data
2007Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:This paper focuses on the switching behaviour of sickness fund enrollees in the Swiss health Insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers, there still remains large premium variations within cantons. This indicates that competition has not been able so far to lead to a single price, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of the Supplementary Insurance on the choice for basic Insurance plan in Switzerland, which has not been studied so far. Our aim is to analyse the two decisions (choice of health plan, subscription to Supplementary Insurance contracts). We use the data of the OFAS survey conducted in 2000 on health plan choice and import some additional data on the sickness funds (number of enrollees, premiums). The decision to switch is estimated by both logit and a fixed-effects logit models; two main explanatory variables are studied: premiums (for basic Insurance contracts) and Supplementary Insurance. The results suggest that holding a Supplementary Insurance contract substantially decreases the propensity to switch. The switching decision is positively influenced by the expected gain of switching, measured by the premium differential. The expected gain of switching is higher for switchers with no Supplementary Insurance (CHF 19.44) than for switchers with Supplementary Insurance (CHF 13.06). The income level has a direct positive influence on the propensity to buy a Supplementary Insurance. This finding suggests that the purchase of Supplementary Insurance is influenced, not only by risk aversion, but also by the willingness to pay for the goods covered by the Supplementary Insurance, which would be higher for rich people. Bad health has a negative influence on the subscription to a Supplementary contract, but is no longer significant when the income is introduced into the specification. All the information about health is captured by the income level, a low income being strongly correlated with a bad health status. Income and a Supplementary Insurance contract are observable by the Insurance company, and can be used as tools for selection.
Brigitte Dormont - One of the best experts on this subject based on the ideXlab platform.
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Supplementary Health Insurance and Regulation of Healthcare Systems
2019Co-Authors: Brigitte DormontAbstract:Most developed nations provide generous coverage of care services, using either a tax financed healthcare system or social health Insurance. Such systems pursue efficiency and equity in care provision. Efficiency means that expenditures are minimized for a given level of care services. Equity means that individuals with equal needs have equal access to the benefit package. In order to limit expenditures, social health Insurance systems explicitly limit their benefit package. Moreover, most such systems have introduced cost sharing so that beneficiaries bear some cost when using care services. These limits on coverage create room for private Insurance that complements or supplements social health Insurance. Everywhere, social health Insurance coexists along with voluntarily purchased Supplementary private Insurance. While the latter generally covers a small portion of health expenditures, it can interfere with the functioning of social health Insurance. Supplementary health Insurance can be detrimental to efficiency through several mechanisms. It limits competition in managed competition settings. It favors excessive care consumption through coverage of cost sharing and of services that are complementary to those included in social Insurance benefits. It can also hinder achievement of the equity goals inherent to social Insurance. Supplementary Insurance creates inequality in access to services included in the social benefits package. Individuals with high incomes are more likely to buy Supplementary Insurance, and the additional care consumption resulting from better coverage creates additional costs that are borne by social health Insurance. In addition, there are other anti-redistributive mechanisms from high to low risks. Social health Insurance should be designed, not as an isolated institution, but with an awareness of the existence—and the possible expansion—of Supplementary health Insurance.
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Assurance maladie en Suisse: l'assurance supplémentaire nuit-elle à la concurrence sur l'assurance de base ?
2013Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:Many countries have introduced competition in health Insurance markets. Managed competition settings have been implemented in order to avoid risk selection problems. In Germany, the Netherlands, Switzerland and Israel citizens can choose between different providers for basic coverage. In this article, we focus on the specific case of Switzerland which implemented managed competition in basic health Insurance markets in 1996. We study to what extent consumer choice for one's basic health plan may interact with the decision to subscribe to Supplementary Insurance. The organization of social health Insurance in France is currently very different from the Swiss system. However the question of regulating complementary health care Insurance markets in France may be discussed in the middle/long run using the Swiss model. In Switzerland, competition in basic health Insurance markets has not been effective so far. There is no evidence of premium convergence within cantons. Consumers have been reluctant to switch to less expensive funds. We investigate one possible barrier to switching behavior, namely the influence of Supplementary Insurance. We show that low switching rates are the result of the existence of two health Insurance markets which are regulated differently: the basic health Insurance market where risk selection is prohibited and the Supplementary health Insurance market where risk selection practices are allowed. We show that holding a Supplementary contract reduces the probability of switching basic Insurance provider for those with poor self-assessed health but has no effect on the switching behavior of enrollees in good/very good health. The efficient management of competition in the basic Insurance market may suffer from a lack of adequate regulation in the Supplementary market.
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The influence of Supplementary health Insurance on switching behaviour: evidence from Swiss data
Health Economics, 2009Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:his paper focuses on the switching behaviour of enrolees in the Swiss basic health Insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers in basic Insurance, there is limited evidence of premium convergence within cantons. This indicates that competition has not been effective so far, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of Supplementary Insurance. We use survey data on health plan choice (a sample of 1943 individuals whose switching behaviours were observed between 1997 and 2000) as well as administrative data relative to all Insurance companies that operated in the 26 Swiss cantons between 1996 and 2005. The decision to switch and the decision to subscribe to a Supplementary contract are jointly estimated. Our findings show that holding a Supplementary Insurance contract substantially decreases the propensity to switch. However, there is no negative impact of Supplementary Insurance on switching when the individual assesses his/her health as 'very good'. Our results give empirical support to one possible mechanism through which Supplementary Insurance might influence switching decisions: given that subscribing to basic and Supplementary contracts with two different insurers may induce some administrative costs for the subscriber, holding Supplementary Insurance acts as a barrier to switch if customers who consider themselves 'bad risks' also believe that insurers reject applications for Supplementary Insurance on these grounds. In comparison with previous research, our main contribution is to offer a possible explanation for consumer inertia. Our analysis illustrates how consumer choice for one's basic health plan interacts with the decision to subscribe to Supplementary Insurance.
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The influence of Supplementary health Insurance on switching behaviour: evidence on Swiss data
2007Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:This paper focuses on the switching behaviour of sickness fund enrollees in the Swiss health Insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers, there still remains large premium variations within cantons. This indicates that competition has not been able so far to lead to a single price, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of the Supplementary Insurance on the choice for basic Insurance plan in Switzerland, which has not been studied so far. Our aim is to analyse the two decisions (choice of health plan, subscription to Supplementary Insurance contracts). We use the data of the OFAS survey conducted in 2000 on health plan choice and import some additional data on the sickness funds (number of enrollees, premiums). The decision to switch is estimated by both logit and a fixed-effects logit models; two main explanatory variables are studied: premiums (for basic Insurance contracts) and Supplementary Insurance. The results suggest that holding a Supplementary Insurance contract substantially decreases the propensity to switch. The switching decision is positively influenced by the expected gain of switching, measured by the premium differential. The expected gain of switching is higher for switchers with no Supplementary Insurance (CHF 19.44) than for switchers with Supplementary Insurance (CHF 13.06). The income level has a direct positive influence on the propensity to buy a Supplementary Insurance. This finding suggests that the purchase of Supplementary Insurance is influenced, not only by risk aversion, but also by the willingness to pay for the goods covered by the Supplementary Insurance, which would be higher for rich people. Bad health has a negative influence on the subscription to a Supplementary contract, but is no longer significant when the income is introduced into the specification. All the information about health is captured by the income level, a low income being strongly correlated with a bad health status. Income and a Supplementary Insurance contract are observable by the Insurance company, and can be used as tools for selection.
Harald Tauchmann - One of the best experts on this subject based on the ideXlab platform.
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Less Social Health Insurance - More Private Supplementary Insurance? - Empirical Evidence from Germany
Journal of Policy Modeling, 2011Co-Authors: Boris Augurzky, Harald TauchmannAbstract:Abstract Based on individual level data from Germany, we analyze the effect of changes in the compulsory benefit package of the social health Insurance on the demand for Supplementary private Insurance, employing a difference-in-differences approach. The focus is on the exclusion of dental prostheses from the benefit package in 1997 and its re-inclusion in 1999. Individuals born prior to 1979 serve as control group because only the young were affected by the reform. No significant effect on the demand for Supplementary health Insurance is found. Thus, the notion of clients making informed choices about their health Insurances’ coverage is not supported.
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Less Social Health Insurance - More Private Supplementary Insurance? - Empirical Evidence from Germany
SSRN Electronic Journal, 2008Co-Authors: Boris Augurzky, Harald TauchmannAbstract:This paper uses individual level data to analyze the effect of changes in the compulsory benefit package of the German statutory health Insurance scheme on the demand for private Supplementary Insurance. In particular, we aim at measuring the effect of excluding dentures from the benefit package in 1997 as well as the effect of re-including them in 1999. A difference-in-differences estimator is used. Individuals born prior to 1979 serve as control group because only the young were affected by the reform. Our results do not exhibit any significant effects on the demand for Supplementary health Insurance. Thus, the hypothesis that clients do make informed choices about their health Insurances' coverage is not supported.
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Less Social Health Insurance – More Private Supplementary Insurance? – Empirical Evidence from Germany
2008Co-Authors: Boris Augurzky, Harald TauchmannAbstract:This paper uses individual level data to analyze the effect of changes in the compulsory benefit package of the German statutory health Insurance scheme on the demand for private Supplementary Insurance. In particular, we aim at measuring the effect of excluding dentures from the benefit package in 1997 as well as the effect of re-including them in 1999. A difference-in-differences estimator is used. Individuals born prior to 1979 serve as control group because only the young were affected by the reform. Our results do not exhibit any significant effects on the demand for Supplementary health Insurance. Thus, the hypothesis that clients do make informed choices about their health Insurances' coverage is not supported.
Boris Augurzky - One of the best experts on this subject based on the ideXlab platform.
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Less Social Health Insurance - More Private Supplementary Insurance? - Empirical Evidence from Germany
Journal of Policy Modeling, 2011Co-Authors: Boris Augurzky, Harald TauchmannAbstract:Abstract Based on individual level data from Germany, we analyze the effect of changes in the compulsory benefit package of the social health Insurance on the demand for Supplementary private Insurance, employing a difference-in-differences approach. The focus is on the exclusion of dental prostheses from the benefit package in 1997 and its re-inclusion in 1999. Individuals born prior to 1979 serve as control group because only the young were affected by the reform. No significant effect on the demand for Supplementary health Insurance is found. Thus, the notion of clients making informed choices about their health Insurances’ coverage is not supported.
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Less Social Health Insurance - More Private Supplementary Insurance? - Empirical Evidence from Germany
SSRN Electronic Journal, 2008Co-Authors: Boris Augurzky, Harald TauchmannAbstract:This paper uses individual level data to analyze the effect of changes in the compulsory benefit package of the German statutory health Insurance scheme on the demand for private Supplementary Insurance. In particular, we aim at measuring the effect of excluding dentures from the benefit package in 1997 as well as the effect of re-including them in 1999. A difference-in-differences estimator is used. Individuals born prior to 1979 serve as control group because only the young were affected by the reform. Our results do not exhibit any significant effects on the demand for Supplementary health Insurance. Thus, the hypothesis that clients do make informed choices about their health Insurances' coverage is not supported.
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Less Social Health Insurance – More Private Supplementary Insurance? – Empirical Evidence from Germany
2008Co-Authors: Boris Augurzky, Harald TauchmannAbstract:This paper uses individual level data to analyze the effect of changes in the compulsory benefit package of the German statutory health Insurance scheme on the demand for private Supplementary Insurance. In particular, we aim at measuring the effect of excluding dentures from the benefit package in 1997 as well as the effect of re-including them in 1999. A difference-in-differences estimator is used. Individuals born prior to 1979 serve as control group because only the young were affected by the reform. Our results do not exhibit any significant effects on the demand for Supplementary health Insurance. Thus, the hypothesis that clients do make informed choices about their health Insurances' coverage is not supported.
Pierre-yves Geoffard - One of the best experts on this subject based on the ideXlab platform.
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Assurance maladie en Suisse: l'assurance supplémentaire nuit-elle à la concurrence sur l'assurance de base ?
2013Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:Many countries have introduced competition in health Insurance markets. Managed competition settings have been implemented in order to avoid risk selection problems. In Germany, the Netherlands, Switzerland and Israel citizens can choose between different providers for basic coverage. In this article, we focus on the specific case of Switzerland which implemented managed competition in basic health Insurance markets in 1996. We study to what extent consumer choice for one's basic health plan may interact with the decision to subscribe to Supplementary Insurance. The organization of social health Insurance in France is currently very different from the Swiss system. However the question of regulating complementary health care Insurance markets in France may be discussed in the middle/long run using the Swiss model. In Switzerland, competition in basic health Insurance markets has not been effective so far. There is no evidence of premium convergence within cantons. Consumers have been reluctant to switch to less expensive funds. We investigate one possible barrier to switching behavior, namely the influence of Supplementary Insurance. We show that low switching rates are the result of the existence of two health Insurance markets which are regulated differently: the basic health Insurance market where risk selection is prohibited and the Supplementary health Insurance market where risk selection practices are allowed. We show that holding a Supplementary contract reduces the probability of switching basic Insurance provider for those with poor self-assessed health but has no effect on the switching behavior of enrollees in good/very good health. The efficient management of competition in the basic Insurance market may suffer from a lack of adequate regulation in the Supplementary market.
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The influence of Supplementary health Insurance on switching behaviour: evidence from Swiss data
Health Economics, 2009Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:his paper focuses on the switching behaviour of enrolees in the Swiss basic health Insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers in basic Insurance, there is limited evidence of premium convergence within cantons. This indicates that competition has not been effective so far, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of Supplementary Insurance. We use survey data on health plan choice (a sample of 1943 individuals whose switching behaviours were observed between 1997 and 2000) as well as administrative data relative to all Insurance companies that operated in the 26 Swiss cantons between 1996 and 2005. The decision to switch and the decision to subscribe to a Supplementary contract are jointly estimated. Our findings show that holding a Supplementary Insurance contract substantially decreases the propensity to switch. However, there is no negative impact of Supplementary Insurance on switching when the individual assesses his/her health as 'very good'. Our results give empirical support to one possible mechanism through which Supplementary Insurance might influence switching decisions: given that subscribing to basic and Supplementary contracts with two different insurers may induce some administrative costs for the subscriber, holding Supplementary Insurance acts as a barrier to switch if customers who consider themselves 'bad risks' also believe that insurers reject applications for Supplementary Insurance on these grounds. In comparison with previous research, our main contribution is to offer a possible explanation for consumer inertia. Our analysis illustrates how consumer choice for one's basic health plan interacts with the decision to subscribe to Supplementary Insurance.
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The influence of Supplementary health Insurance on switching behaviour: evidence on Swiss data
2007Co-Authors: Brigitte Dormont, Pierre-yves Geoffard, Karine LamiraudAbstract:This paper focuses on the switching behaviour of sickness fund enrollees in the Swiss health Insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers, there still remains large premium variations within cantons. This indicates that competition has not been able so far to lead to a single price, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of the Supplementary Insurance on the choice for basic Insurance plan in Switzerland, which has not been studied so far. Our aim is to analyse the two decisions (choice of health plan, subscription to Supplementary Insurance contracts). We use the data of the OFAS survey conducted in 2000 on health plan choice and import some additional data on the sickness funds (number of enrollees, premiums). The decision to switch is estimated by both logit and a fixed-effects logit models; two main explanatory variables are studied: premiums (for basic Insurance contracts) and Supplementary Insurance. The results suggest that holding a Supplementary Insurance contract substantially decreases the propensity to switch. The switching decision is positively influenced by the expected gain of switching, measured by the premium differential. The expected gain of switching is higher for switchers with no Supplementary Insurance (CHF 19.44) than for switchers with Supplementary Insurance (CHF 13.06). The income level has a direct positive influence on the propensity to buy a Supplementary Insurance. This finding suggests that the purchase of Supplementary Insurance is influenced, not only by risk aversion, but also by the willingness to pay for the goods covered by the Supplementary Insurance, which would be higher for rich people. Bad health has a negative influence on the subscription to a Supplementary contract, but is no longer significant when the income is introduced into the specification. All the information about health is captured by the income level, a low income being strongly correlated with a bad health status. Income and a Supplementary Insurance contract are observable by the Insurance company, and can be used as tools for selection.
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Assurance maladie : la gestion du risque long
2000Co-Authors: Pierre-yves GeoffardAbstract:This paper offers a theoretical investigation of long term coverage of health risks. I focus upon two key features in a long term perspective: first, individuals bear the risk that their risk category may change through time ; second, in the long run, uncertainty may be " radical, " i.e., difficult to probabilise. After briefly summarising the dynamic elements of theories of solidarity (according to Leon Bourgeois and John Rawls), the second part presents recent economic approaches of long term risk management, and reviews the solutions that have been offered in the area of health care. The third part attempts to apply these solutions to the French health Insurance system made of two parts : mandatory public Insurance, and private Supplementary Insurance, regulated by the Loi Evin. Lastly, the final section offers a first examination, both theoretical and descriptive, of the comparative advantages of mutuals (non profit) and Insurance companies (for profit), two forms of private institutions involved in health Insurance, focusing on the long term aspects of this activity. The conclusion insists on the limits of the analysis, and suggests paths for future research.