Bunching at the kink: Implications for spending responses to health insurance contracts

• 成果类型: Article
• 署名作者: Einav, Liran; Finkelstein, Amy; Schrimpf, Paul
• 署名单位: Stanford University; National Bureau of Economic Research; Massachusetts Institute of Technology (MIT); University of British Columbia
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2016.11.011
• 发表日期: 2017
• 页码: 27-40
• 关键词: Bunching; medicare; health insurance; health care

摘要

A large literature in empirical public finance relies on bunching to identify a behavioral response to non-linear incentives and to translate this response into an economic object to be used counterfactually. We conduct this type of analysis in the context of prescription drug insurance for the elderly in Medicare Part D, where a kink in the individual's budget set generates substantial bunching in annual drug expenditure around the famous donut bile. We show that different alternative economic models can match the basic bunching pattern, but have very different quantitative implications for the counterfactual spending response to alternative insurance contracts. These findings illustrate the importance of modeling choices in mapping a compelling reduced form pattern into an economic object of interest. (C) 2016 Elsevier B.V. All rights reserved.