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Health Insurance and Life Style Choices: Identifying the Ex Ante Moral Hazard

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  • STANCIOLE Anderson

Abstract

There is extensive debate in the literature about the practical significance of the concept of ex-ante moral hazard. This paper uses data from the 1999-2003 PSID waves to estimate a structural model of individual choice of insurance coverage and four life style related decisions: heavy smoking, heavy drinking, sedentarism and obesity. The results show that health insurance has significant incentive effects on life style choices, increasing the propensity to heavy smoking, sedentarism and obesity. Somewhat surprisingly, however, health insurance decreases the propensity to heavy drinking. There is also significant correlation among the errors of each equation. The results might also have implications for the design of health financing policies.

Suggested Citation

  • 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.
  • Handle: RePEc:irs:iriswp:2007-10
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    1. Frank A. Sloan & Jan Ostermann & Christopher Conover & Donald H. Taylor, Jr. & Gabriel Picone, 2006. "The Price of Smoking," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262693453, April.
    2. Bruno Jullien & Bernard Salanié & François Salanié, 1999. "Should More Risk-Averse Agents Exert More Effort?," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 24(1), pages 19-28, June.
    3. Jerome Adda & Valérie Lechene, 2004. "On the identification of the effect of smoking on mortality," CeMMAP working papers 13/04, Institute for Fiscal Studies.
    4. 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.
    5. 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.
    6. Jay Bhattacharya & Neeraj Sood, 2006. "Health Insurance and the Obesity Externality," Advances in Health Economics and Health Services Research, in: The Economics of Obesity, pages 279-318, Emerald Group Publishing Limited.
    7. 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.
    8. 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.
    9. Bundorf M. Kate & Herring Bradley & Pauly Mark V., 2010. "Health Risk, Income, and Employment-Based Health Insurance," Forum for Health Economics & Policy, De Gruyter, vol. 13(2), pages 1-35, September.
    10. Kenkel, D., 1988. "The Demand For Preventive Medical Care," Papers 3-88-4, Pennsylvania State - Department of Economics.
    11. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    12. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    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. Christophe Courbage & Béatrice Rey, 2006. "Prudence and optimal prevention for health risks," Post-Print halshs-03353388, HAL.
    15. 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..
    16. 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.
    17. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521747387, September.
    18. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
    19. 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.
    20. 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.
    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.
    22. Wilde, Joachim, 2000. "Identification of multiple equation probit models with endogenous dummy regressors," Economics Letters, Elsevier, vol. 69(3), pages 309-312, December.
    23. 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.
    24. Amy Finkelstein & Kathleen McGarry, 2003. "Private Information and its Effect on Market Equilibrium: New Evidence from Long-Term Care Insurance," NBER Working Papers 9957, National Bureau of Economic Research, Inc.
    25. Lorenzo Cappellari & Stephen P. Jenkins, 2003. "Multivariate probit regression using simulated maximum likelihood," Stata Journal, StataCorp LP, vol. 3(3), pages 278-294, September.
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    Cited by:

    1. Aida Isabel Tavares, 2014. "Health insurance and lifestyles," Applied Economics, Taylor & Francis Journals, vol. 46(16), pages 1910-1923, June.
    2. repec:cup:judgdm:v:8:y:2013:i:2:p:174-178 is not listed on IDEAS
    3. FOUARGE Didier & MUFFELS Ruud & PAVLOPOULOS Dimitris & VERMUNT Jeroen K., 2007. "Who benefits from a job change: The dwarfs or the giants?," IRISS Working Paper Series 2007-16, IRISS at CEPS/INSTEAD.
    4. Chenhao Yu & Huigang Liang & Zhiruo Zhang, 2022. "Does Health Insurance Reduce the Alcohol Consumption? Evidence from China Health and Nutrition Survey," Sustainability, MDPI, vol. 14(9), pages 1-10, May.
    5. Lorenzo Corsini, 2012. "Institutions, Technological Change and Wage Differentials between Skilled and Unskilled Workers: Theory and Evidence from Europe," Research in Labor Economics, in: Research in Labor Economics, pages 1-33, Emerald Group Publishing Limited.
    6. repec:cup:judgdm:v:8:y:2013:i:2:p:161-173 is not listed on IDEAS
    7. MARTIN Ludivine, 2007. "The impact of technological changes on incentives and motivations to work hard," IRISS Working Paper Series 2007-15, IRISS at CEPS/INSTEAD.
    8. Philippe P. F. M. van de Calseyde & Gideon Keren & Marcel Zeelenberg, 2013. "The insured victim effect: When and why compensating harm decreases punishment recommendations," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 8(2), pages 161-173, March.
    9. 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.
    10. Orit E. Tykocinski, 2013. "The insurance effect: How the possession of gas masks reduces the likelihood of a missile attack," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 8(2), pages 174-178, March.
    11. PREJMEREAN Mihaela Cornelia & VASILACHE Simona, 2008. "What's a univesity worth? Changes in the lifestyle and status of post-2000 European Graduates," IRISS Working Paper Series 05, IRISS at CEPS/INSTEAD.
    12. LILLA Marco, 2007. "Income Inequality and Education Premia," IRISS Working Paper Series 2007-11, IRISS at CEPS/INSTEAD.
    13. Prejmerean, Mihaela Cornelia & Vasilache, Simona, 2008. "What's a university worth? Changes in the lifestyle and status of post-2000 European Graduates," IRISS Working Paper Series 2008-05, IRISS at CEPS/INSTEAD.

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    More about this item

    Keywords

    ex ante moral hazard; insurance; life Style; Max Simulated Likelihood;
    All these keywords.

    JEL classification:

    • C15 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Statistical Simulation Methods: General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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