Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare
Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare
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“人”的健康保险：信息摩擦、计划选择与消费者福利
DOI：
10.3386/w19373
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Jonathan T. Kolstad
中科院分区：
文献类型：
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作者：
B. Handel;Jonathan T. Kolstad
传统的保险选择模式是建立在消费者充分知情和理性的基础上，保护自己免受金融风险的影响。在实践中，从一组复杂的非线性合同中选择一个保险计划是一个复杂的决定，通常在没有关于几个潜在重要维度的完整信息的情况下做出。在本文中，我们将健康计划选择和索赔的新管理数据与消费者信息和其他典型的未观察到的偏好因素的独特调查数据相结合，以便分别识别风险偏好、信息摩擦和感知的计划麻烦成本。行政数据和调查数据在个人一级相互关联，从而能够在描述性分析和基于选择模型的分析中深入调查这些微观基础之间的联系。我们发现，消费者在许多重要方面缺乏信息，他们通常被认为理解这些信息，他们认为计划的麻烦成本很高，并根据这些摩擦做出选择。此外，在预期效用模型的背景下，包括我们测量的额外摩擦对风险偏好估计有直接影响，风险偏好估计通常被认为是此类模型中持续的未观察到的偏好异质性的唯一来源。在我们的背景下，我们表明，纳入这些摩擦的衡量标准，会显著降低估计的消费者风险厌恶程度。这一结果既具有积极意义，又具有规范意义，因为风险厌恶通常与信息摩擦具有不同的福利意义。我们评估了反事实菜单设计对福利的影响，发现在不考虑额外摩擦的情况下，风险敞口造成的福利损失是考虑到额外摩擦时的两倍以上，这说明了我们的分析对政策决策的潜在重要性。
Traditional models of insurance choice are predicated on fully informed and rational consumers protecting themselves from exposure to financial risk. In practice, choosing an insurance plan from a set of complex non-linear contracts is a complicated decision often made without full information on several potentially important dimensions. In this paper we combine new administrative data on health plan choices and claims with unique survey data on consumer information and other typically unobserved preference factors in order to separately identify risk preferences, information frictions, and perceived plan hassle costs. The administrative and survey data are linked at the individual level, allowing in-depth investigations of the links between these micro- foundations in both descriptive and choice-model based analyses. We find that consumers lack information on many important dimensions that they are typically assumed to understand, perceive high plan hassle costs, and make choices that depend on these frictions. Moreover, in the context of an expected utility model, including the additional frictions that we measure has direct implications for risk preference estimates, which are typically assumed to be the only source of persistent unobserved preference heterogeneity in such models. In our setting, we show that incorporating measures of these frictions leads to meaningful reductions in estimated consumer risk aversion. This result has both positive and normative implications since risk aversion generally has different welfare implications than information frictions. We assess the welfare impact of a counterfactual menu design and find that the welfare loss from risk exposure when additional frictions are not taken into account is more than double that when they are, illustrating the potential importance of our analysis for policy decisions.