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One of the fundamental tasks in optimal insurance design is mitigating the moral hazard effects inherent in insurance mechanisms. Empirically, relatively little is known about how individual-level time preferences affect selection of insurance options. We use several waves of the Health and Retirement Survey to explore the relationship between revealed time preferences at the individual level and the selection of insurance options for both the under-age-65 population and the Medicare-eligible population. Our results suggest that time preferences are not likely to be fixed across the life cycle, and that they appear to be important predictors of health insurance decisions.

Under the Patient Protection and Affordable Care Act (ACA), many low-income consumers have become eligible for government support to buy health insurance. Whether these consumers are able to take advantage of the support and to make sound decisions about purchasing health insurance likely depends on their knowledge and skills in navigating complex financial products. This ability is frequently referred to as “financial literacy.” We examined the level and distribution of consumers' financial literacy across income groups, using 2012 data collected in the RAND American Life Panel, an internet panel representative of the US population. Low financial literacy was particularly prevalent among individuals with incomes between 100% and 400% of the federal poverty level, many of whom will be eligible for health insurance subsidies. In this group, people who are young, less educated, female, and have less income were more likely to have low financial literacy. Our findings suggest the need for targeted policies to support vulnerable consumers in making good choices for themselves, possibly above and beyond the support measures already part of the ACA.

This qualitative study explores how individuals understand health insurance concepts and make health insurance purchase decisions. The study sought to develop a model of the health insurance decision-making process.

This study used semi-structured interview questions and the micro-moment time-line interview technique with newly hired employees to discuss the steps that individuals follow when making health insurance decisions. The researcher used an open coding approach to analyze the steps listed by each participant, and emergent themes were used to code all interview transcripts in Atlas.ti.

This study identified information tactics used by individuals when evaluating health insurance documentation. The findings also shed light on the personal reflection individuals undertake when making their health insurance choices.

The information needs and preferred information sources identified in this study will be of interest to information professionals and human resources officers providing assistance with health insurance enrolment.

The findings demonstrating that participants characterized their health insurance choice as a shared decision is a novel contribution of this study.

This study aims to examine how the number of choices consumers have influences provider satisfaction, plan satisfaction and positive word-of-mouth (WOM) in the health insurance industry.

Partial least squares (PLS) and structural equation modeling (SmartPLS) was used to conduct multi-group analysis to analyze the structural models. Data were collected online using Amazon mechanical turk, resulting in 425 respondents.

This study finds that the number of choices consumers have impacts the strength of provider and plan satisfaction and positive WOM. Also, this study finds that provider satisfaction is generally more impactful than plan satisfaction when generating positive WOM.

This study extends reactance theory, satisfaction and WOM based on choice options to the health insurance industry where credence attributes are prevalent and the analysis includes two satisfaction constructs in the structural model, whereas multiple satisfaction constructs are often overlooked.

In the spirit of Polachek (1975) and the later work of Becker (1985) on the role of specialization within the family, we examine the relationship between fringe benefits and the division of labor within a married household. The provision of fringe benefits is complicated by their non-additive nature within the household, as well as IRS regulations that stipulate that they be offered in a non-discriminatory manner in order to maintain their tax-exempt status. We model family decisions within a framework in which one spouse specializes in childcare and as a result experiences a reduction in market productive capacity. Our model predicts that the forces toward specialization become stronger as the number of children increase, so that the spouse specializing in childcare will have some combination of lower wages, hours worked, and fringe benefits. We demonstrate that to the extent that labor markets are incomplete, the family is less likely to obtain health insurance from the employer of the spouse that specializes in childcare. Using data from the April 1993 CPS we find evidence consistent with our model.

Purpose – To examine the effects of health insurance types on the use of prescribed medication that treat patients with hypertension, diabetes, and asthma. The study distinguishes between individuals with private health maintenance organization (HMO) plans and private non-HMO plans. The study also distinguishes between people with health insurance and drug coverage and people with health insurance and no drug coverage.

Methods – Joint discrete factor models are estimated to control for endogeneity of each type of coverage.

Findings – The main findings suggest that the effect of health insurance varies across patients with different conditions. The strongest and most significant effect is evident among patients with hypertension while the weakest and least significant is among patients with asthma. These findings suggest that patients with asymptomatic conditions are more likely to exhibit moral hazard than patients with conditions that impose immediate impairment. Additional results suggest that, relative to the uninsured and people with health insurance but no drug coverage, patients with drug coverage are more likely to initiate drug therapy and to consume more medications.

Originality – The results of the study indicate that moral hazard of drug utilization is condition specific. The variation in “silence” of conditions’ symptoms could be a key reason for difference in insurance effects among patients with hypertension, diabetes, and asthma.

Good health is important for the happiness and productivity of employees of any organization and a nation. With the declining government funding for public Universities in Kenya, providing health cover for employees is a real challenge. Thus, the universities have to explore widely acceptable and sustainable options. This study aims to explore the correlations of employee preferences for health care schemes and evaluated the cost implications of each of the available Schemes.

The study applied a multinomial probit analysis on cross-sectional data from Taita Taveta University (TTU) in Kenya's coastal region. Cost-benefit analysis was used to rank alternative healthcare schemes. For triangulation of information, individual interviews were supplemented with key informant interviews.

Two sets of factors, personal attributes of employees and the attributes of the health care provider, were found to drive employee preferences for health care schemes. Thus, the universities need to consider these attributes in their choice sets of health care schemes to gain employee support.

The study was based on a cross-sectional survey that may not capture the dynamic elements in institutional management. Thus, future research may build panel data on the current one for further analysis.

The study found that household characteristics and the perceived attributes of the healthcare providers are key drivers of the preferences. Thus, it is important to consider the characteristics of the employees (for example, age, family sizes, etc.) and attributes of healthcare providers before selecting a healthcare scheme for the workers

This is a pioneer study on the choice of healthcare scheme for institutions of higher learning in Kenya. Universities are made aware of what informs employee's preferences for health schemes. This is important for tailoring health care schemes to match employee preferences for greater satisfaction.

This paper analyzes the effect of dental insurance on utilization of general dentist services by adult US population aged from 25 to 64 years using the ordered probit model with endogenous selection. Our econometric framework accommodates endogeneity of insurance and the ordered nature of the measure of dental utilization. The study finds strong evidence of endogeneity of dental insurance to utilization and identifies interesting patterns of nonlinear dependencies between the dental insurance status and individual's age and income. The calculated average treatment effect supports the claim of adverse selection into the treated (insured) state and indicates a strong positive incentives effect of dental insurance.

The purpose of this paper is to explore how psychological variables are related to real-life insurance consumption. Specifically, the authors focus on whether emotions and psychological traits can improve the predictability of insurance demand, taking traditional socioeconomic variables under control.

The approach used was in-person survey, based on a traditional questionnaire, the Barratt Impulsiveness Scale and a psycho-physiological task (Iowa Gambling Task (IGT)).

A selective role of emotions and psychological traits has been proven to exist when comparing different insurance policies. Life and casualty insurance are affected by emotional arousal to losses; indemnity insurance by fear of the unknown, whereas health insurance by impulsivity.

The findings indicate that individual insurance consumption may be amplified by not cognitive components. Future research should concentrate on testing the effect of further psychological traits related to pure risk coverage.

The results may be of interest for insurers in order to know what drives insurance demand with respect to different kinds of pure risks.

For policymakers, it is important to understand how psychological factors affect consumer behavior in order to incorporate such perspective into modern insurance policy measures. An analysis of such factors may also increase the self-consciousness of insurance consumers and enrich consumer self-protection.

The authors propose an interdisciplinary approach to analyze insurance demand and test different kinds of insurance coverage, suggesting not homogenous hedging behaviors in relation to specific ambiguous events.

Health care systems are evaluated by the triad of access, quality, and cost. This article presents evidence-based outcomes of multiple measures of concern with the United States (U.S.) health care system and proposes a universal health care system as the solution of choice. One third of the U.S. population is either non-insured or underinsured. Lack of quality care is shown by several indicators. Cost concerns are noted in cross-national studies which emphasize that the U.S. spends twice as much for health care but with less access for its citizens to health care. The presidential election of Fall 2004 provides a “window of opportunity” for this policy to be enacted.