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Estimating the tradeoff between risk protection and moral hazard with a nonlinear budget set model of health insurance

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  • Kowalski, Amanda E.
Abstract
Insurance induces a tradeoff between the welfare gains from risk protection and the welfare losses from moral hazard. Empirical work traditionally estimates each side of the tradeoff separately, potentially yielding mutually inconsistent results. I develop a nonlinear budget set model of health insurance that allows for both simultaneously. Nonlinearities in the budget set arise from deductibles, coinsurance rates, and stoplosses that alter moral hazard as well as risk protection. I illustrate the properties of my model by estimating it using data on employer sponsored health insurance from a large firm.

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  • Kowalski, Amanda E., 2015. "Estimating the tradeoff between risk protection and moral hazard with a nonlinear budget set model of health insurance," International Journal of Industrial Organization, Elsevier, vol. 43(C), pages 122-135.
    • Handle: RePEc:eee:indorg:v:43:y:2015:i:c:p:122-135
    DOI: 10.1016/j.ijindorg.2015.08.001
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    Cited by:

    1. Michael Gerfin & Boris Kaiser & Christian Schmid, 2015. "Healthcare Demand in the Presence of Discrete Price Changes," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1164-1177, September.
    2. Toshiaki Iizuka & Hitoshi Shigeoka, 2018. "Free for Children? Patient Cost-sharing and Healthcare Utilization," NBER Working Papers 25306, National Bureau of Economic Research, Inc.
    3. Steven W. Hemelt & Kevin M. Stange, 2016. "Marginal Pricing and Student Investment in Higher Education," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 35(2), pages 441-471, April.
    4. Harold L. Cole & Soojin Kim & Dirk Krueger, 2012. "Analyzing the Effects of Insuring Health Risks: On the Trade-off between Short Run Insurance Benefits vs. Long Run Incentive Costs," NBER Working Papers 18572, National Bureau of Economic Research, Inc.
    5. Kairies-Schwarz, Nadja & Harrison, Glenn W. & Han, Johann, 2018. "Deductibles and Health Care Utilization: An Experiment on the Role of Forward-Looking Behavior," VfS Annual Conference 2018 (Freiburg, Breisgau): Digital Economy 181588, Verein für Socialpolitik / German Economic Association.
    6. Aviva Aron-Dine & Liran Einav & Amy Finkelstein, 2013. "The RAND Health Insurance Experiment, Three Decades Later," Journal of Economic Perspectives, American Economic Association, vol. 27(1), pages 197-222, Winter.
    7. Kate Ho & Robin S. Lee, 2023. "Health insurance menu design for large employers," RAND Journal of Economics, RAND Corporation, vol. 54(4), pages 598-637, December.
    8. Westerhout, Ed & Folmer, Kees, 2018. "The Effects of Capping Co-Insurance Payments," Discussion Paper 2018-050, Tilburg University, Center for Economic Research.
    9. Jason Abaluck & Jonathan Gruber & Ashley Swanson, 2015. "Prescription Drug Use under Medicare Part D: A Linear Model of Nonlinear Budget Sets," NBER Working Papers 20976, National Bureau of Economic Research, Inc.
    10. Gregory Cox, 2018. "Almost Sure Uniqueness of a Global Minimum Without Convexity," Papers 1803.02415, arXiv.org, revised Feb 2019.
    11. Benjamin R. Handel, 2013. "Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts," American Economic Review, American Economic Association, vol. 103(7), pages 2643-2682, December.
    12. Guo, Audrey & Zhang, Jonathan, 2019. "What to expect when you are expecting: Are health care consumers forward-looking?," Journal of Health Economics, Elsevier, vol. 67(C).
    13. Klein, T.J.; & Salm, M.; & Upadhyay, S.;, 2024. "Patient cost-sharing and redistribution in health insurance," Health, Econometrics and Data Group (HEDG) Working Papers 24/15, HEDG, c/o Department of Economics, University of York.
    14. Ed Westerhout & Kees Folmer, 2013. "Why it may hurt to be insured: the effects of capping coinsurance payments," CPB Discussion Paper 239, CPB Netherlands Bureau for Economic Policy Analysis.
    15. Aviva Aron-Dine & Liran Einav & Amy Finkelstein & Mark R. Cullen, 2012. "Moral Hazard in Health Insurance: How Important Is Forward Looking Behavior?," NBER Working Papers 17802, National Bureau of Economic Research, Inc.
    16. Masaki Takahashi, 2023. "Insurance coverage, long-term care utilization, and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(8), pages 1383-1397, November.
    17. Lin, Haizhen & Sacks, Daniel W., 2019. "Intertemporal substitution in health care demand: Evidence from the RAND Health Insurance Experiment," Journal of Public Economics, Elsevier, vol. 175(C), pages 29-43.
    18. Sebastián Fleitas & Gautam Gowrisankaran & Anthony Lo Sasso, 2018. "Reclassification Risk in the Small Group Health Insurance Market," NBER Working Papers 24663, National Bureau of Economic Research, Inc.
    19. Abaluck, Jason & Gruber, Jonathan & Swanson, Ashley, 2018. "Prescription drug use under Medicare Part D: A linear model of nonlinear budget sets," Journal of Public Economics, Elsevier, vol. 164(C), pages 106-138.
    20. Benjamin R. Handel, 2011. "Adverse Selection and Switching Costs in Health Insurance Markets: When Nudging Hurts," NBER Working Papers 17459, National Bureau of Economic Research, Inc.
    21. Haizhen Lin & Daniel W. Sacks, 2016. "Intertemporal Substitution in Health Care Demand: Evidence from the RAND Health Insurance Experiment," NBER Working Papers 22802, National Bureau of Economic Research, Inc.
    22. Klein, Tobias J. & Salm, Martin & Upadhyay, Suraj, 2024. "Patient Cost-Sharing and Redistribution in Health Insurance," IZA Discussion Papers 16778, Institute of Labor Economics (IZA).
    23. Benjamin R. Handel & Jonathan T. Kolstad, 2013. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare," NBER Working Papers 19373, National Bureau of Economic Research, Inc.
    24. David Powell & Dana P. Goldman, 2014. "Moral Hazard and Adverse Selection in Private Health Insurance," Working Papers WR-1032, RAND Corporation.
    25. Westerhout, Ed & Folmer, Kees, 2018. "The Effects of Capping Co-Insurance Payments," Other publications TiSEM 828746fb-4fb0-465b-bdff-3, Tilburg University, School of Economics and Management.

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    More about this item

    Keywords

    Risk protection; Moral hazard; Nonlinear budget set; Health insurance;
    All these keywords.

    JEL classification:

    • H2 - Public Economics - - Taxation, Subsidies, and Revenue
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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