IDEAS home Printed from https://ideas.repec.org/a/pal/gpprii/v33y2008i4d10.1057_gpp.2008.27.html
   My bibliography  Save this article

Health Insurance and Lifestyle Choices: Identifying Ex Ante Moral Hazard in the US Market

Author

Listed:
  • Anderson E Stanciole

    (University of York)

Abstract

There is extensive debate in the literature about the practical significance of ex ante moral hazard in health insurance markets. This paper uses data from the U.S. Panel Study of Income Dynamics (1999–2003) to estimate a structural model of individual choice of insurance coverage and four lifestyle decisions: heavy smoking, heavy drinking, lack of exercise and obesity. The results show that health insurance has significant incentive effects on lifestyle choices, increasing the propensity to heavy smoking, lack of exercise and obesity and decreasing the propensity to heavy drinking. There is also significant correlation between the errors of each equation. The results might have implications for the design of health financing policies.

Suggested Citation

  • Anderson E Stanciole, 2008. "Health Insurance and Lifestyle Choices: Identifying Ex Ante Moral Hazard in the US Market," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 33(4), pages 627-644, October.
    • Handle: RePEc:pal:gpprii:v:33:y:2008:i:4:d:10.1057_gpp.2008.27
    DOI: 10.1057/gpp.2008.27
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1057/gpp.2008.27
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1057/gpp.2008.27?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Jerome Adda & Valérie Lechene, 2004. "On the identification of the effect of smoking on mortality," CeMMAP working papers 13/04, Institute for Fiscal Studies.
    2. repec:bla:geneva:v:29:y:2004:i:4:p:719-727 is not listed on IDEAS
    3. Pauly, Mark V. & Held, Philip J, 1990. "Benign moral hazard and the cost-effectiveness analysis of insurance coverage," Journal of Health Economics, Elsevier, vol. 9(4), pages 447-461, December.
    4. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    5. Christophe Courbage & Béatrice Rey, 2006. "Prudence and optimal prevention for health risks," Post-Print halshs-03353388, HAL.
    6. David Hemenway, 1990. "Propitious Selection," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 105(4), pages 1063-1069.
    7. Cardon, James H & Hendel, Igal, 2001. "Asymmetric Information in Health Insurance: Evidence from the National Medical Expenditure Survey," RAND Journal of Economics, The RAND Corporation, vol. 32(3), pages 408-427, Autumn.
    8. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, Enero.
    9. Rashad, Inas & Kaestner, Robert, 2004. "Teenage sex, drugs and alcohol use: problems identifying the cause of risky behaviors," Journal of Health Economics, Elsevier, vol. 23(3), pages 493-503, May.
    10. Lorenzo Cappellari & Stephen P. Jenkins, 2003. "Multivariate probit regression using simulated maximum likelihood," Stata Journal, StataCorp LLC, vol. 3(3), pages 278-294, September.
    11. de Meza, David & Webb, David C, 2001. "Advantageous Selection in Insurance Markets," RAND Journal of Economics, The RAND Corporation, vol. 32(2), pages 249-262, Summer.
    12. Kenkel, Donald S, 1991. "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy, University of Chicago Press, vol. 99(2), pages 287-305, April.
    13. Pierre-Andre Chiappori & Bernard Salanie, 2000. "Testing for Asymmetric Information in Insurance Markets," Journal of Political Economy, University of Chicago Press, vol. 108(1), pages 56-78, February.
    14. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-648, July-Aug..
    15. Christophe Courbage & Béatrice Rey, 2006. "Prudence and optimal prevention for health risks," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1323-1327, December.
    16. Christophe Courbage & Augustin de Coulon, 2004. "Prevention and Private Health Insurance in the U.K," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 719-727, October.
    17. José A. Pagán & Andrea Puig & Beth J. Soldo, 2007. "Health insurance coverage and the use of preventive services by Mexican adults," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1359-1369.
    18. Wilde, Joachim, 2000. "Identification of multiple equation probit models with endogenous dummy regressors," Economics Letters, Elsevier, vol. 69(3), pages 309-312, December.
    19. Christophe Courbage & Augustin de Coulon, 2004. "Prevention and Private Health Insurance in the U.K," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 719-727, October.
    20. Hemenway, David, 1992. "Propitious Selection in Insurance," Journal of Risk and Uncertainty, Springer, vol. 5(3), pages 247-251, July.
    21. José A. Pagán & Andrea Puig & Beth J. Soldo, 2007. "Health insurance coverage and the use of preventive services by Mexican adults," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1359-1369, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. STANCIOLE Anderson, 2007. "Health Insurance and Life Style Choices: Identifying the Ex Ante Moral Hazard," IRISS Working Paper Series 2007-10, IRISS at CEPS/INSTEAD.
    2. Hanming Fang & Michael P. Keane & Dan Silverman, 2008. "Sources of Advantageous Selection: Evidence from the Medigap Insurance Market," Journal of Political Economy, University of Chicago Press, vol. 116(2), pages 303-350, April.
    3. Fichera, Eleonora & Sutton, Matt, 2011. "State and self investments in health," Journal of Health Economics, Elsevier, vol. 30(6), pages 1164-1173.
    4. Dardanoni, Valentino & Li Donni, Paolo, 2012. "Incentive and selection effects of Medigap insurance on inpatient care," Journal of Health Economics, Elsevier, vol. 31(3), pages 457-470.
    5. Peilu Zhang & Marco A. Palma, 2021. "Compulsory Versus Voluntary Insurance: An Online Experiment," American Journal of Agricultural Economics, John Wiley & Sons, vol. 103(1), pages 106-125, January.
    6. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    7. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    8. 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.
    9. Clifford Afoakwah & Joshua Byrnes & Paul Scuffham & Son Nghiem, 2023. "Testing for selection bias and moral hazard in private health insurance: Evidence from a mixed public‐private health system," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 3-24, January.
    10. Raj Chetty & Amy Finkelstein, 2012. "Social Insurance: Connecting Theory to Data," NBER Working Papers 18433, National Bureau of Economic Research, Inc.
    11. Bruno Jullien & Bernard Salanié & François Salanié, 2000. "Screening Risk-Averse Agents Under Moral Hazard," Working Papers 2000-41, Center for Research in Economics and Statistics.
    12. Aida Isabel Tavares & Pedro Pita Barros, 2011. "Ex-ante Moral Hazard and Primary Prevention, evidence from Portugal," Working Papers de Economia (Economics Working Papers) 56, Departamento de Economia, Gestão e Engenharia Industrial, Universidade de Aveiro.
    13. Karl Ove Aarbu, 2017. "Asymmetric Information in the Home Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 84(1), pages 35-72, March.
    14. Bolhaar, Jonneke & Lindeboom, Maarten & van der Klaauw, Bas, 2012. "A dynamic analysis of the demand for health insurance and health care," European Economic Review, Elsevier, vol. 56(4), pages 669-690.
    15. Philippe De Donder & Marie-Louise Leroux & François Salanié, 2023. "Advantageous selection without moral hazard," Journal of Risk and Uncertainty, Springer, vol. 67(1), pages 21-43, August.
    16. Alma Cohen & Peter Siegelman, 2010. "Testing for Adverse Selection in Insurance Markets," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 39-84, March.
    17. De Donder, Philippe & Hindriks, Jean, 2006. "Does Propitious Selection Explain Why Riskier People Buy Less Insurance?," CEPR Discussion Papers 5640, C.E.P.R. Discussion Papers.
    18. J François Outreville, 2010. "The Geneva Risk and Insurance Review 2009: In Quest of Behavioural Insurance," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 35(3), pages 484-497, July.
    19. Capatina, Elena, 2020. "Selection in employer sponsored health insurance," Journal of Health Economics, Elsevier, vol. 71(C).
    20. Nick Netzer & Florian Scheuer, 2010. "Competitive screening in insurance markets with endogenous wealth heterogeneity," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 44(2), pages 187-211, August.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pal:gpprii:v:33:y:2008:i:4:d:10.1057_gpp.2008.27. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.palgrave-journals.com/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.