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Self-Control and Demand for Preventive Health: Evidence from Hypertension in India

Listed author(s):
  • Liang Bai
  • Benjamin Handel
  • Edward Miguel
  • Gautam Rao

Self-control problems constitute a potential explanation for the under-investment in preventive health care observed in low-income countries. A commonly proposed policy tool to solve such problems is offering consumers commitment devices. We conduct a field experiment to evaluate the effectiveness of different types of theoretically-motivated commitment contracts in increasing preventive doctor visits by hypertensive patients in rural India. We document varying levels of takeup of the different commitment contracts, but find no effects on actual doctor visits or individual health outcomes. Thus, a substantial number of individuals pay for commitments, but then fail to follow through on the specified task, losing money without experiencing any health benefit. We develop and structurally estimate a pre-specified model of consumer behavior under present bias with varying levels of naivete. The results are consistent with a large share of individuals being partially naive about their own self-control problems: in other words, they are sophisticated enough to demand some commitment, but overly optimistic about whether a given commitment is sufficiently strong to be effective. The results suggest that commitment devices may in practice be welfare diminishing, at least in some contexts, and serve as a cautionary tale about the role of these contracts in the health care sector.

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File URL: http://www.nber.org/papers/w23727.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 23727.

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Date of creation: Aug 2017
Handle: RePEc:nbr:nberwo:23727
Note: DEV HC
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  1. Esther Duflo & Michael Kremer & Jonathan Robinson, 2011. "Nudging Farmers to Use Fertilizer: Theory and Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 101(6), pages 2350-2390, October.
  2. Ashraf, Nava & Karlan, Dean & Yin, Wesley, 2010. "Female Empowerment: Impact of a Commitment Savings Product in the Philippines," World Development, Elsevier, vol. 38(3), pages 333-344, March.
  3. Anett John (née Hofmann), 2014. "When Commitment Fails - Evidence from a Regular Saver Product in the Philippines," STICERD - Economic Organisation and Public Policy Discussion Papers Series 55, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE.
  4. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521747387, March.
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