Effect of Individual Decision-making Abilities on Long-term Care Insurance Purchase

描述（由申请人提供）：消费者主导的退休计划的兴起和医疗保险计划中个人选择的增加，为美国老年人创造了一套越来越复杂的金融和保险相关决策。选择是否为长期护理（LTC）的费用投保，这是任何公共福利计划都不包括在内的，这是另一个个人承担重大责任做出审慎财务决策的例子。然而，目前尚不清楚的是，消费者是否具备必要的技能和能力，以做出最佳的，甚至是充分的经济选择，为潜在的支出做准备，这是退休人员面临的最大的无保险财务风险之一。事实上，有证据表明，如果有需要，许多退休人员在经济上准备不足，无法支付长期服务，这往往导致他们严重依赖医疗补助。此外，关于需要长期护理保险（LTCI）的可能性、此类服务的成本以及医疗补助和医疗保险在资助这种护理方面的作用的大量错误信息已被记录在案，这表明在购买长期护理保险（LTCI）方面存在良好决策障碍。随着政策制定者寻求提高个人对未来长期医疗费用的准备，并减少该领域的医疗补助支出，了解个人决策能力在适当响应市场激励和达成最佳购买决策方面的作用是很重要的。本文的总体目标是确定个人决策能力的影响，包括固有的

DESCRIPTION (provided by applicant): The rise of consumer-directed retirement planning and increases in personal choice within the Medicare program have created an increasingly complex set of financial and insurance-related decisions for aging Americans. Choosing whether to insure against the cost of long-term care (LTC), which is not covered by any public entitlement program, is another example of the substantial responsibility placed on individuals to make prudent financial decisions. It is not clear, however, whether consumers have the necessary skills and competencies to make optimal, or even sufficient, economic choices in preparation for potential expenses that represent one of the largest uninsured financial risks facing retirees. Indeed, there is evidence to suggest that many retirees are financially ill-prepared to pay for LTC services should the need arise, often resulting in a heavy reliance on Medicaid coverage. Furthermore, considerable misinformation about the likelihood of needing LTC, the costs of such services, and the role of Medicaid and Medicare in financing this care has been documented, giving some indication that barriers to good decision making with regards to long-term care insurance (LTCI) purchase exist. As policy makers seek to improve individual preparation for future LTC expenses and reduce Medicaid spending in this area, it is important to understand the role of one s decision- making abilities in appropriately responding to market incentives and arriving at an optimal purchasing decision. The overall goal of this dissertation is to determine the effect of individual decision-making abilities, including inherent cognitive abilities and accumulated knowledge, on achieving optimal insuring behavior with regards to private LTCI policies. I will achieve this goal by utilizing a dual process theory of decision-making from the field of cognitive psychology to conceptualize how consumers make decisions and the individual competencies that may promote or inhibit optimal choices. Furthermore, I will evaluate the impact of such competencies on adherence to normative guidelines, derived from the economic theory of expected utility, with regards to LTCI purchase in a nationally representative sample of Americans aged 50 and older. The information generated by this dissertation will contribute to the scientific body of knowledge regarding how consumers make purchasing decisions in an insurance marketplace and the role of suboptimal decision- making in explaining the limited up-take of private LTCI. Furthermore, the results will inform policy makers about the potential impacts of policy approaches aimed at increasing LTCI purchase, particularly those that rely on consumer education.