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

描述（由申请人提供）：消费者导向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日益复杂的财务和保险相关决策。选择是否投保长期护理（LTC）的费用，这是不包括在任何公共权利计划，是另一个例子，对个人的重大责任，作出审慎的财务决定。然而，目前尚不清楚消费者是否有必要的技能和能力做出最佳甚至足够的经济选择，为潜在的支出做准备，这些支出是退休人员面临的最大的未保险财务风险之一。事实上，有证据表明，许多退休人员在经济上没有准备好支付长期护理服务，如果需要的话，往往导致严重依赖医疗补助保险。此外，关于需要长期护理的可能性、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经被记录在案，这表明存在购买长期护理保险（LTCI）的良好决策障碍。随着政策制定者寻求改善个人对未来LTC费用的准备并减少这一领域的医疗补助支出，重要的是要了解一个人的决策能力在适当应对市场激励和达成最佳购买决策方面的作用。本论文的总体目标是确定个人决策能力的影响，包括内在的 认知能力和积累的知识，实现最佳的保险行为方面的私人LTCI政策。为了实现这一目标，我将利用认知心理学领域的决策双过程理论来概念化消费者如何做出决策以及可能促进或抑制最佳选择的个人能力。此外，我将评估这种能力的影响，遵守规范性的指导方针，来自预期效用的经济理论，关于LTCI购买在全国代表性的样本50岁及以上的美国人。本论文所产生的信息将有助于科学的知识体系，关于消费者如何在保险市场上做出购买决策，以及次优决策在解释私人LTCI有限的摄取中的作用。此外，研究结果将告知政策制定者旨在增加LTCI购买的政策方法的潜在影响，特别是那些依赖于消费者教育的政策方法。

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.