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

在先前有关不确定情况下的决策工作的基础上，这个项目解决了在人们选择医疗保健选项的背景下风险规避与风险收益的影响。这篇博士论文试图调查(1)与传统的健康保险计划相比，健康储蓄账户(HSA)是否鼓励更谨慎的医疗支出，以及(2)决策者的一般动机倾向是否有助于解释常见的决策错误。HSA应该增加人格责任，减少不必要的护理，但也可能期望它们通过操作决策倾向来减少必要的护理，以避免“损失”。该项目在涉及健康领域决策的结果方面将传统健康福利计划与HSA进行了比较。该项目还测试了在每种类型的健康计划下，个人在不同决策任务之间的动机偏好(无论是对“收获”还是对“损失”)的影响。三个实验将改变消费者拥有的医疗保健计划的类型以及他们接收信息的方式。这些实验还衡量了消费者总体动机倾向的影响。这些研究将考察(A)获得癌症筛查的意图和为癌症筛查付费的意愿，(B)获得免疫注射的意图和付费意愿，以及(C)面对假想的肺癌时的首选治疗方案和为两种可能的治疗方案付费的意愿。这些实验将评估HSA范例促进医疗保健消费者理性的能力。实验结果将揭示HSA是促进还是抑制理性决策的偏离。如果HSA减少了非理性的决策结果，立法者可能会期待拥有HSA的医疗消费者更加谨慎。另一方面，如果HSA允许或加剧决策错误，立法者可能会重新考虑个人医疗账户的效用。

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.