Doctoral Dissertation Research: Motivation & Loss Aversion in the Health Savings Account Paradigm

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Building upon prior work concerning decision making under uncertainty, this project addresses the impact of risk-avoidance versus risk-gain in the context of people's choice of healthcare options. This doctoral dissertation seeks to investigate (1) whether Health Savings Accounts (HSAs) encourage more prudent health care spending compared to traditional health insurance plans and (2) whether decision makers' general motivational tendencies can help explain common decision errors. HSAs are supposed to increase personality responsibility and reduce unnecessary care, but they might also be expected to decrease necessary care through the operation of decision making tendencies to avoid "losses." The project compares traditional health benefit plans with HSAs in terms of outcomes that involve decision-making in the health domain. The project also tests the impact of individuals' motivational preferences (either towards "gains" or towards "losses") between decision tasks under each type of health plan. Three experiments will vary the type of healthcare plan that consumers have and the manner in which they receive information. The experiments also measure the impact of consumers' general motivational tendencies. The studies will examine (a) intentions to obtain cancer screening and willingness to pay for cancer screening, (b) intentions to obtain an immunization injection and willingness to pay for it, and (c) preferred treatment option in the face of an imagined lung cancer and willingness to pay for each of the two possible treatments.These experiments will assess the capability of the HSA paradigm to facilitate rationality among healthcare consumers. The experimental results will reveal whether HSAs facilitate or inhibit deviations from rational decision making. If HSAs reduce irrational decision outcomes, lawmakers may expect enhanced prudence among healthcare consumers who possess HSAs. If, on the other hand, HSAs permit or exacerbate decision making errors, lawmakers might reconsider the utility of individual healthcare accounts.