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Employee Choice of Health Insurance

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  • Ellis, Randall P

Abstract

A new specification of health-insurance-plan choice is developed that uses a nonparametric functional form for the loss function used to evaluate insurance premiums and uncertain out-of-pocket expenditure. The approach is implemented on data resulting from one firm's implementation of a new health plan with three distinct health insurance options. Health expenditure differences greater than 500 percent are observed, indicating extremely strong biased selection. Plan choices are consistent with a convex loss function for small losses, which suggests that consumers underweight high-loss/low-probability outcomes relative to low-loss/high-probability ones. Copyright 1989 by MIT Press.

Suggested Citation

  • Ellis, Randall P, 1989. "Employee Choice of Health Insurance," The Review of Economics and Statistics, MIT Press, vol. 71(2), pages 215-223, May.
  • Handle: RePEc:tpr:restat:v:71:y:1989:i:2:p:215-23
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    Cited by:

    1. Joan T. Schmit & Jia-Hsing Yeh, 2003. "An Economic Analysis of Auto Compensation Systems: Choice Experiences From New Jersey and Pennsylvania," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 70(4), pages 601-628.
    2. Bo, H. & Lensink, R., 2000. "Is the investment-uncertainty relationship non-linear? : an emperical [i.e. empirical] analysis for the Netherlands," Research Report 00E44, University of Groningen, Research Institute SOM (Systems, Organisations and Management).
    3. Randall Ellis, 2012. "Five questions for health economists," International Journal of Health Economics and Management, Springer, vol. 12(3), pages 217-233, September.
    4. Jean Marie Abraham & William B. Vogt & Martin Gaynor, 2002. "Household Demand for Employer-Based Health Insurance," NBER Working Papers 9144, National Bureau of Economic Research, Inc.
    5. Altman, Daniel & Cutler, David & Zeckhauser, Richard, 2003. "Enrollee mix, treatment intensity, and cost in competing indemnity and HMO plans," Journal of Health Economics, Elsevier, vol. 22(1), pages 23-45, January.
    6. Carine Franc & Marc Perronnin & Aurélie Pierre, 2010. "Subscribing to Supplemental Health Insurance in France: A Dynamic Analysis of Adverse Selection," Working Papers DT35, IRDES institut for research and information in health economics, revised Dec 2010.
    7. Fernando Ruiz & Liliana Amaya & Stella Venegas, 2007. "Progressive segmented health insurance: Colombian health reform and access to health services," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 3-18.
    8. van de Ven, Wynand P. M. M. & van Vliet, ReneC. J. A., 1995. "Consumer information surplus and adverse selection in competitive health insurance markets: An empirical study," Journal of Health Economics, Elsevier, vol. 14(2), pages 149-169, June.
    9. Alan C. Monheit & Thomas M. Selden, 2000. "Cross-subsidization in the market for employment-related health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 9(8), pages 699-714.
    10. Ricardo Sanhueza & Jaime Ruiz-Tagle, 2002. "Choosing Health Insurance in a Dual Health Care System: The Chilean Case," Journal of Applied Economics, Universidad del CEMA, vol. 5, pages 157-184, May.
    11. repec:dgr:rugsom:00e44 is not listed on IDEAS
    12. Robert Nuscheler & Thomas Knaus, 2005. "Risk selection in the German public health insurance system," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1253-1271.
    13. Andreas Million & Regina T. Riphahn & Achim Wambach, 2003. "Incentive effects in the demand for health care: a bivariate panel count data estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(4), pages 387-405.
    14. John A. Rizzo, 2005. "Are HMOs bad for health maintenance?," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1117-1131.
    15. Lu Ji & Fei Liu, 2007. "HMO versus non-HMO private managed care plans: an investigation on pre-switch consumption," Health Care Management Science, Springer, vol. 10(1), pages 67-80, February.
    16. M. Kate Bundorf, 2010. "The Effects of Offering Health Plan Choice Within Employment-Based Purchasing Groups," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 105-127.

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