title: Choice of health insurance by families of the mentally ill.
abstract: This paper investigates whether choice of health insurance is influenced by the perceived mental and physical health of family members among a sample of policy-holders with private health insurance. A multinomial probit model of the choice among major medical coverage only, traditional full coverage, and coverage through a health maintenance organization is estimated. Results indicate that the presence of at least one family member who rates his or her general health as poor does not affect the policy-holder's choice of health insurance. However, the presence of at least one family member considered at risk of mental illness does in some instances affect the policy-holder's choice of health insurance: We observe significant effects for policy-holders who are female, black, have some college education, work for a large firm, and live in an urban area. These findings suggest that adverse selection may arise when individuals are able to choose between health insurance policies with different degrees of coverage for mental health care and that such effects are far more pronounced for those people who consider themselves at risk for mental illness than physical illness.
authors.affiliation: Indiana University-Purdue University at Indianapolis, USA.
authors.forename: P
authors.initials: P
authors.lastname: Deb
authors.forename: V
authors.initials: V
authors.lastname: Wilcox-Gök
authors.forename: A
authors.initials: A
authors.lastname: Holmes
authors.forename: J
authors.initials: J
authors.lastname: Rubin
mesh_terms: D001741:Black or African American; D002755:Choice Behavior; D005191:Family Characteristics; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006801:Humans; D007342:Insurance Benefits / Q000191:economics*; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000706:statistics & numerical data*; D007354:Insurance, Major Medical / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000191:economics*; D018803:Models, Economic; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States