BEHAVIORAL HAZARD IN HEALTH INSURANCE

• 成果类型: Article
• 署名作者: Baicker, Katherine; Mullainathan, Sendhil; Schwartzstein, Joshua
• 署名单位: Harvard University; Harvard University
• 刊物名称: QUARTERLY JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0033-5533
• DOI: 10.1093/qje/qjv029
• 发表日期: 2015
• 页码: 1623-1667
• 关键词: Moral hazard; emergency-department; Medication adherence; PHARMACY BENEFITS; PATIENT ADHERENCE; welfare loss; CHOICE; care; prescription; ECONOMICS

摘要

A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample evidence, though, that people misuse care for a different reason: mistakes, or behavioral hazard.'' Much high-value care is underused even when patient costs are low, and some useless care is bought even when patients face the full cost. In the presence of behavioral hazard, welfare calculations using only the demand curve can be off by orders of magnitude or even be the wrong sign. We derive optimal copay formulas that incorporate both moral and behavioral hazard, providing a theoretical foundation for value-based insurance design and a way to interpret behavioral nudges.'' Once behavioral hazard is taken into account, health insurance can do more than just provide financial protection-it can also improve health care efficiency.