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Subjective Expectations for Health Service Use and Consequences for Health Insurance Behavior

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  • Kettlewell, Nathan

    (University of Technology, Sydney)

Abstract

I evaluate the accuracy of people's subjective probability expectations for using various health services. Subjective expectations closely reflect patterns of observed utilization, are predicted by the same covariates as observed utilization, and correlate with objective measures of risk. At the same time, observable characteristics like age and health are weakly predictive of service demand. Through a series of examples, I demonstrate how subjective expectations can provide new insights about health behavior, specifically in the areas of asymmetric information, moral hazard and estimating welfare attributable to private care. The findings support collecting subjective expectations about health services in household surveys for use in applied research.

Suggested Citation

  • Kettlewell, Nathan, 2020. "Subjective Expectations for Health Service Use and Consequences for Health Insurance Behavior," IZA Discussion Papers 13445, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp13445
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    1. Catherine C. Eckel & Philip J. Grossman, 2002. "Sex Differences and Statistical Stereotyping in Attitudes Toward Financial Risk," Monash Economics Working Papers archive-03, Monash University, Department of Economics.
    2. Michael Hurd & Maarten Van Rooij & Joachim Winter, 2011. "Stock market expectations of Dutch households," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 26(3), pages 416-436, April.
    3. Kettlewell, Nathan, 2019. "Risk preference dynamics around life events," Journal of Economic Behavior & Organization, Elsevier, vol. 162(C), pages 66-84.
    4. Tversky, Amos & Kahneman, Daniel, 1992. "Advances in Prospect Theory: Cumulative Representation of Uncertainty," Journal of Risk and Uncertainty, Springer, vol. 5(4), pages 297-323, October.
    5. Frank Sloan & Lindsey Eldred & Tong Guo & Yanzhi Xu, 2013. "Are people overoptimistic about the effects of heavy drinking?," Journal of Risk and Uncertainty, Springer, vol. 47(1), pages 93-127, August.
    6. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2011. "Waiting times for elective surgery and the decision to buy private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 68-86, September.
    7. Amy Finkelstein & Erzo F. P. Luttmer & Matthew J. Notowidigdo, 2013. "What Good Is Wealth Without Health? The Effect Of Health On The Marginal Utility Of Consumption," Journal of the European Economic Association, European Economic Association, vol. 11, pages 221-258, January.
    8. Patrick Bajari & Christina Dalton & Han Hong & Ahmed Khwaja, 2014. "Moral hazard, adverse selection, and health expenditures: A semiparametric analysis," RAND Journal of Economics, RAND Corporation, vol. 45(4), pages 747-763, December.
    9. Joan Costa‐Font & Jaume García‐Villar, 2009. "Risk Attitudes And The Demand For Private Health Insurance: The Importance Of ‘Captive Preferences’," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 80(4), pages 499-519, December.
    10. Kiil, Astrid, 2012. "What characterises the privately insured in universal health care systems? A review of the empirical evidence," Health Policy, Elsevier, vol. 106(1), pages 60-75.
    11. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    12. Charles F. Manski & John D. Straub, 2000. "Worker Perceptions of Job Insecurity in the Mid-1990s: Evidence from the Survey of Economic Expectations," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 447-479.
    13. Adeline Delavande & Basit Zafar, 2019. "University Choice: The Role of Expected Earnings, Nonpecuniary Outcomes, and Financial Constraints," Journal of Political Economy, University of Chicago Press, vol. 127(5), pages 2343-2393.
    14. Michael D. Hurd, 2009. "Subjective Probabilities in Household Surveys," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 543-564, May.
    15. Jeffrey M. Wooldridge, 2015. "Control Function Methods in Applied Econometrics," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 420-445.
    16. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    17. Nathan Kettlewell, 2019. "Utilization and Selection in an Ancillaries Health Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(4), pages 989-1017, December.
    18. Lundborg, Petter & Lindgren, Bjorn, 2002. "Risk Perceptions and Alcohol Consumption among Young People," Journal of Risk and Uncertainty, Springer, vol. 25(2), pages 165-183, September.
    19. Amy Finkelstein & James Poterba, 2004. "Adverse Selection in Insurance Markets: Policyholder Evidence from the U.K. Annuity Market," Journal of Political Economy, University of Chicago Press, vol. 112(1), pages 183-208, February.
    20. Luba M Pardo & Wen-Qing Li & Shih-Jen Hwang & Joris A C Verkouteren & Albert Hofman & André G Uitterlinden & Peter Kraft & Constance Turman & Jiali Han & Eunyoung Cho & Joanne M Murabito & Daniel Levy, 2017. "Genome-Wide Association Studies of Multiple Keratinocyte Cancers," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-12, January.
    21. Sandra Hopkins & Michael P. Kidd & Aydogan Ulker, 2013. "Private Health Insurance Status and Utilisation of Dental Services in Australia," The Economic Record, The Economic Society of Australia, vol. 89(285), pages 194-206, June.
    22. Nathan Kettlewell, 2020. "Policy Choice and Product Bundling in a Complicated Health Insurance Market: Do People Get It Right?," Journal of Human Resources, University of Wisconsin Press, vol. 55(2), pages 566-610.
    23. Charles F. Manski, 2004. "Measuring Expectations," Econometrica, Econometric Society, vol. 72(5), pages 1329-1376, September.
    24. Wändi Bruine de Bruin & Andrew Parker & Jürgen Maurer, 2011. "Assessing small non-zero perceptions of chance: The case of H1N1 (swine) flu risks," Journal of Risk and Uncertainty, Springer, vol. 42(2), pages 145-159, April.
    25. Denise Doiron & Nathan Kettlewell, 2020. "Family formation and the demand for health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 523-533, April.
    26. Petter Lundborg & Bj–rn Lindgren, 2004. "Do They Know What They are Doing? Risk Perceptions and Smoking Behaviour Among Swedish Teenagers," Journal of Risk and Uncertainty, Springer, vol. 28(3), pages 261-286, May.
    27. Arni, Patrick & Dragone, Davide & Goette, Lorenz & Ziebarth, Nicolas R., 2021. "Biased health perceptions and risky health behaviors—Theory and evidence," Journal of Health Economics, Elsevier, vol. 76(C).
    28. Khwaja, Ahmed & Silverman, Dan & Sloan, Frank & Wang, Yang, 2009. "Are mature smokers misinformed?," Journal of Health Economics, Elsevier, vol. 28(2), pages 385-397, March.
    29. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334, March.
    30. Wändi Bruine de Bruin & Paul S. Fischbeck & Neil A. Stiber & Baruch Fischhoff, 2002. "What Number is “Fifty‐Fifty”?: Redistributing Excessive 50% Responses in Elicited Probabilities," Risk Analysis, John Wiley & Sons, vol. 22(4), pages 713-723, August.
    31. Adeline Delavande & Hans-Peter Kohler, 2016. "HIV/AIDS-related Expectations and Risky Sexual Behaviour in Malawi," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 83(1), pages 118-164.
    32. Buchmueller, Thomas C. & Fiebig, Denzil G. & Jones, Glenn & Savage, Elizabeth, 2013. "Preference heterogeneity and selection in private health insurance: The case of Australia," Journal of Health Economics, Elsevier, vol. 32(5), pages 757-767.
    33. Denise Doiron & Nathan Kettlewell, 2018. "The Effect of Health Insurance on the Substitution between Public and Private Hospital Care," The Economic Record, The Economic Society of Australia, vol. 94(305), pages 135-154, June.
    34. Péter Hudomiet & Gábor Kézdi & Robert J. Willis, 2011. "Stock market crash and expectations of American households," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 26(3), pages 393-415, April.
    35. Adeline Delavande & Hans-Peter Kohler, 2012. "The Impact of HIV Testing on Subjective Expectations and Risky Behavior in Malawi," Demography, Springer;Population Association of America (PAA), vol. 49(3), pages 1011-1036, August.
    36. Katherine Carman & Peter Kooreman, 2014. "Probability perceptions and preventive health care," Journal of Risk and Uncertainty, Springer, vol. 49(1), pages 43-71, August.
    37. Viscusi, W Kip, 1991. "Age Variations in Risk Perceptions and Smoking Decisions," The Review of Economics and Statistics, MIT Press, vol. 73(4), pages 577-588, November.
    38. Manski, Charles F. & Molinari, Francesca, 2010. "Rounding Probabilistic Expectations in Surveys," Journal of Business & Economic Statistics, American Statistical Association, vol. 28(2), pages 219-231.
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    More about this item

    Keywords

    subjective expectations; beliefs; subjective probabilities; health insurance; healthcare demand;
    All these keywords.

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • D84 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Expectations; Speculations
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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