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


  • Anderson E Stanciole

    () (Department of Economics and Related Studies, University of York, Heslington, York YO10 5DD, UK.)


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. The Geneva Papers (2008) 33, 627–644. doi:10.1057/gpp.2008.27

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:p:627-644

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    Cited by:

    1. Wanyue Dong & Jianmin Gao & Zhongliang Zhou & Ruhai Bai & Yue Wu & Min Su & Chi Shen & Xin Lan & Xiao Wang, 2018. "Effects of China’s urban basic health insurance on preventive care service utilization and health behaviors: Evidence from the China Health and Nutrition Survey," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-14, December.
    2. Dhaval M. Dave & Robert Kaestner & George L. Wehby, 2015. "Does Medicaid Coverage for Pregnant Women Affect Prenatal Health Behaviors?," NBER Working Papers 21049, National Bureau of Economic Research, Inc.
    3. Botkins, Elizabeth Robison, 2015. "Does Health Insurance Encourage Obesity? A Moral Hazard Study," 2015 AAEA & WAEA Joint Annual Meeting, July 26-28, San Francisco, California 206228, Agricultural and Applied Economics Association.
    4. Annette Hofmann & Casey Rothschild, 2019. "On the efficiency of self-protection with spillovers in risk," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 44(2), pages 207-221, September.
    5. Ning Neil Yu & Xi Zhu, 2018. "Affordable care encourages healthy living: Theory and evidence from China's new cooperative medical scheme," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 2051-2066, December.
    6. Aida Isabel Tavares, 2020. "Voluntary private health insurance demand determinants and risk preferences: Evidence from SHARE," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(3), pages 685-703, May.
    7. Aparna Soni, 2020. "The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1586-1605, December.
    8. Aistov, Andrey V. (Аистов, Андрей) & Aleksandrova, Ekaterina A. (Александрова, Екатерина), 2018. "Ex Post Moral Hazard in Private Health Insurance [Постконтрактный Оппортунизм На Рынке Добровольного Медицинского Страхования]," Economic Policy, Russian Presidential Academy of National Economy and Public Administration, vol. 3, pages 148-181, June.
    9. Brandon Pope & Abhijit Deshmukh & Andrew Johnson & James Rohack, 2014. "Multilateral Contracting And Prevention," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 397-409, April.

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