title: Selection on Moral Hazard in Health Insurance.
abstract: We use employee-level panel data from a single firm to explore the possibility that individuals may select insurance coverage in part based on their anticipated behavioral ("moral hazard") response to insurance, a phenomenon we label "selection on moral hazard." Using a model of plan choice and medical utilization, we present evidence of heterogeneous moral hazard as well as selection on it, and explore some of its implications. For example, we show that, at least in our context, abstracting from selection on moral hazard could lead to over-estimates of the spending reduction associated with introducing a high-deductible health insurance option.
authors.affiliation: Department of Economics, Stanford University, 579 Serra Mall, Stanford, CA 94305-6072 ( leinav@stanford.edu ) and NBER.
authors.forename: Liran
authors.initials: L
authors.lastname: Einav
authors.affiliation: Department of Economics, MIT, 50 Memorial Drive, Cambrdige, MA 02142-1347 ( afink@mit.edu ) and NBER.
authors.forename: Amy
authors.initials: A
authors.lastname: Finkelstein
authors.affiliation: Department of Economics, MIT, 50 Memorial Drive, Cambrdige, MA 02142-1347 ( sryan@mit.edu ) and NBER.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ryan
authors.affiliation: Department of Economics, The University of British Columbia, 997-1873 East Mall, Vancouver B.C. Canada V6T 1Z1 ( schrimpf@mail.ubc.ca ).
authors.forename: Paul
authors.initials: P
authors.lastname: Schrimpf
authors.affiliation: Department of Internal Medicine, School of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305-5414 ( mrcullen@stanford.edu ) and NBER.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
mesh_terms: D002755:Choice Behavior; D003258:Consumer Behavior; D003669:Deductibles and Coinsurance; D005382:Financing, Personal; D015438:Health Behavior; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000191:economics* / Q000706:statistics & numerical data*
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