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

在先前关于不确定性下的决策工作的基础上，本项目探讨了在人们选择医疗保健方案的背景下，风险规避与风险获得的影响。本博士论文旨在调查(1)健康储蓄账户（HSAs）是否鼓励比传统健康保险计划更谨慎的医疗保健支出；(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。HSAs应该增加人格责任和减少不必要的照顾，但它们也可能被期望通过决策倾向的操作来减少必要的照顾，以避免“损失”。该项目就涉及保健领域决策的结果对传统保健福利计划与保健福利计划进行了比较。该项目还测试了个人的动机偏好（对“收益”或“损失”的偏好）在每种健康计划下的决策任务之间的影响。三个实验将改变消费者所拥有的医疗保健计划的类型和他们接收信息的方式。实验还测量了消费者一般动机倾向的影响。这些研究将检查(a)获得癌症筛查的意愿和支付癌症筛查的意愿，(b)获得免疫注射的意愿和支付的意愿，以及(c)面对想象中的肺癌时的首选治疗方案和支付两种可能治疗方案的意愿。这些实验将评估HSA范式促进医疗保健消费者理性的能力。实验结果将揭示HSAs是促进还是抑制理性决策的偏离。如果HSAs减少了非理性的决策结果，立法者可能会期望拥有HSAs的医疗保健消费者更加谨慎。另一方面，如果HSAs允许或加剧决策错误，立法者可能会重新考虑个人医疗保健账户的效用。

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.