IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp13445.html
   My bibliography  Save this paper

Subjective Expectations for Health Service Use and Consequences for Health Insurance Behavior

Author

Listed:
  • Kettlewell, Nathan

    (University of Technology, Sydney)

Abstract

I evaluate the accuracy of people's subjective probability expectations for using various health services. Subjective expectations closely reflect patterns of observed utilization, are predicted by the same covariates as observed utilization, and correlate with objective measures of risk. At the same time, observable characteristics like age and health are weakly predictive of service demand. Through a series of examples, I demonstrate how subjective expectations can provide new insights about health behavior, specifically in the areas of asymmetric information, moral hazard and estimating welfare attributable to private care. The findings support collecting subjective expectations about health services in household surveys for use in applied research.

Suggested Citation

  • Kettlewell, Nathan, 2020. "Subjective Expectations for Health Service Use and Consequences for Health Insurance Behavior," IZA Discussion Papers 13445, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp13445
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp13445.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Catherine C. Eckel & Philip J. Grossman, 2002. "Sex Differences and Statistical Stereotyping in Attitudes Toward Financial Risk," Monash Economics Working Papers archive-03, Monash University, Department of Economics.
    2. Michael Hurd & Maarten Van Rooij & Joachim Winter, 2011. "Stock market expectations of Dutch households," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 26(3), pages 416-436, April.
    3. Kettlewell, Nathan, 2019. "Risk preference dynamics around life events," Journal of Economic Behavior & Organization, Elsevier, vol. 162(C), pages 66-84.
    4. Tversky, Amos & Kahneman, Daniel, 1992. "Advances in Prospect Theory: Cumulative Representation of Uncertainty," Journal of Risk and Uncertainty, Springer, vol. 5(4), pages 297-323, October.
    5. Frank Sloan & Lindsey Eldred & Tong Guo & Yanzhi Xu, 2013. "Are people overoptimistic about the effects of heavy drinking?," Journal of Risk and Uncertainty, Springer, vol. 47(1), pages 93-127, August.
    6. Meliyanni Johar & Glenn Jones & Michael Keane & Elizabeth Savage & Olena Stavrunova, 2011. "Waiting times for elective surgery and the decision to buy private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 68-86, September.
    7. Amy Finkelstein & Erzo F. P. Luttmer & Matthew J. Notowidigdo, 2013. "What Good Is Wealth Without Health? The Effect Of Health On The Marginal Utility Of Consumption," Journal of the European Economic Association, European Economic Association, vol. 11, pages 221-258, January.
    8. Patrick Bajari & Christina Dalton & Han Hong & Ahmed Khwaja, 2014. "Moral hazard, adverse selection, and health expenditures: A semiparametric analysis," RAND Journal of Economics, RAND Corporation, vol. 45(4), pages 747-763, December.
    9. Joan Costa‐Font & Jaume García‐Villar, 2009. "Risk Attitudes And The Demand For Private Health Insurance: The Importance Of ‘Captive Preferences’," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 80(4), pages 499-519, December.
    10. Kiil, Astrid, 2012. "What characterises the privately insured in universal health care systems? A review of the empirical evidence," Health Policy, Elsevier, vol. 106(1), pages 60-75.
    11. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    12. Charles F. Manski & John D. Straub, 2000. "Worker Perceptions of Job Insecurity in the Mid-1990s: Evidence from the Survey of Economic Expectations," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 447-479.
    13. Adeline Delavande & Basit Zafar, 2019. "University Choice: The Role of Expected Earnings, Nonpecuniary Outcomes, and Financial Constraints," Journal of Political Economy, University of Chicago Press, vol. 127(5), pages 2343-2393.
    14. Michael D. Hurd, 2009. "Subjective Probabilities in Household Surveys," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 543-564, May.
    15. Jeffrey M. Wooldridge, 2015. "Control Function Methods in Applied Econometrics," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 420-445.
    16. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    17. Nathan Kettlewell, 2019. "Utilization and Selection in an Ancillaries Health Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(4), pages 989-1017, December.
    18. Lundborg, Petter & Lindgren, Bjorn, 2002. "Risk Perceptions and Alcohol Consumption among Young People," Journal of Risk and Uncertainty, Springer, vol. 25(2), pages 165-183, September.
    19. Amy Finkelstein & James Poterba, 2004. "Adverse Selection in Insurance Markets: Policyholder Evidence from the U.K. Annuity Market," Journal of Political Economy, University of Chicago Press, vol. 112(1), pages 183-208, February.
    20. Luba M Pardo & Wen-Qing Li & Shih-Jen Hwang & Joris A C Verkouteren & Albert Hofman & André G Uitterlinden & Peter Kraft & Constance Turman & Jiali Han & Eunyoung Cho & Joanne M Murabito & Daniel Levy, 2017. "Genome-Wide Association Studies of Multiple Keratinocyte Cancers," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-12, January.
    21. Sandra Hopkins & Michael P. Kidd & Aydogan Ulker, 2013. "Private Health Insurance Status and Utilisation of Dental Services in Australia," The Economic Record, The Economic Society of Australia, vol. 89(285), pages 194-206, June.
    22. Nathan Kettlewell, 2020. "Policy Choice and Product Bundling in a Complicated Health Insurance Market: Do People Get It Right?," Journal of Human Resources, University of Wisconsin Press, vol. 55(2), pages 566-610.
    23. Charles F. Manski, 2004. "Measuring Expectations," Econometrica, Econometric Society, vol. 72(5), pages 1329-1376, September.
    24. Wändi Bruine de Bruin & Andrew Parker & Jürgen Maurer, 2011. "Assessing small non-zero perceptions of chance: The case of H1N1 (swine) flu risks," Journal of Risk and Uncertainty, Springer, vol. 42(2), pages 145-159, April.
    25. Denise Doiron & Nathan Kettlewell, 2020. "Family formation and the demand for health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 523-533, April.
    26. Petter Lundborg & Bj–rn Lindgren, 2004. "Do They Know What They are Doing? Risk Perceptions and Smoking Behaviour Among Swedish Teenagers," Journal of Risk and Uncertainty, Springer, vol. 28(3), pages 261-286, May.
    27. Arni, Patrick & Dragone, Davide & Goette, Lorenz & Ziebarth, Nicolas R., 2021. "Biased health perceptions and risky health behaviors—Theory and evidence," Journal of Health Economics, Elsevier, vol. 76(C).
    28. Khwaja, Ahmed & Silverman, Dan & Sloan, Frank & Wang, Yang, 2009. "Are mature smokers misinformed?," Journal of Health Economics, Elsevier, vol. 28(2), pages 385-397, March.
    29. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334, March.
    30. Wändi Bruine de Bruin & Paul S. Fischbeck & Neil A. Stiber & Baruch Fischhoff, 2002. "What Number is “Fifty‐Fifty”?: Redistributing Excessive 50% Responses in Elicited Probabilities," Risk Analysis, John Wiley & Sons, vol. 22(4), pages 713-723, August.
    31. Adeline Delavande & Hans-Peter Kohler, 2016. "HIV/AIDS-related Expectations and Risky Sexual Behaviour in Malawi," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 83(1), pages 118-164.
    32. 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.
    33. Denise Doiron & Nathan Kettlewell, 2018. "The Effect of Health Insurance on the Substitution between Public and Private Hospital Care," The Economic Record, The Economic Society of Australia, vol. 94(305), pages 135-154, June.
    34. Péter Hudomiet & Gábor Kézdi & Robert J. Willis, 2011. "Stock market crash and expectations of American households," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 26(3), pages 393-415, April.
    35. Adeline Delavande & Hans-Peter Kohler, 2012. "The Impact of HIV Testing on Subjective Expectations and Risky Behavior in Malawi," Demography, Springer;Population Association of America (PAA), vol. 49(3), pages 1011-1036, August.
    36. Katherine Carman & Peter Kooreman, 2014. "Probability perceptions and preventive health care," Journal of Risk and Uncertainty, Springer, vol. 49(1), pages 43-71, August.
    37. Viscusi, W Kip, 1991. "Age Variations in Risk Perceptions and Smoking Decisions," The Review of Economics and Statistics, MIT Press, vol. 73(4), pages 577-588, November.
    38. Manski, Charles F. & Molinari, Francesca, 2010. "Rounding Probabilistic Expectations in Surveys," Journal of Business & Economic Statistics, American Statistical Association, vol. 28(2), pages 219-231.
    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. Ha Trong Nguyen & Huong Thu Le & Luke Connelly & Francis Mitrou, 2023. "Accuracy of self‐reported private health insurance coverage," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2709-2729, December.
    2. Frank A. Sloan, 2024. "Subjective beliefs, health, and health behaviors," Journal of Risk and Uncertainty, Springer, vol. 69(2), pages 105-144, October.
    3. Nathan Kettlewell, 2019. "Utilization and Selection in an Ancillaries Health Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(4), pages 989-1017, December.
    4. Yokoo, Hide-Fumi & Arimura, Toshi H. & Chattopadhyay, Mriduchhanda & Katayama, Hajime, 2023. "Subjective risk belief function in the field: Evidence from cooking fuel choices and health in India," Journal of Development Economics, Elsevier, vol. 161(C).
    5. Buchmueller, Thomas C. & Cheng, Terence C. & Pham, Ngoc T.A. & Staub, Kevin E., 2021. "The effect of income-based mandates on the demand for private hospital insurance and its dynamics," Journal of Health Economics, Elsevier, vol. 75(C).
    6. Katherine Carman & Peter Kooreman, 2014. "Probability perceptions and preventive health care," Journal of Risk and Uncertainty, Springer, vol. 49(1), pages 43-71, August.
    7. Joachim Winter & Amelie Wuppermann, 2014. "Do They Know What Is At Risk? Health Risk Perception Among The Obese," Health Economics, John Wiley & Sons, Ltd., vol. 23(5), pages 564-585, May.
    8. Charles F. Manski, 2018. "Survey Measurement of Probabilistic Macroeconomic Expectations: Progress and Promise," NBER Macroeconomics Annual, University of Chicago Press, vol. 32(1), pages 411-471.
    9. Denise Doiron & Nathan Kettlewell, 2020. "Family formation and the demand for health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 523-533, April.
    10. Nils Grevenbrock & Max Groneck & Alexander Ludwig & Alexander Zimper, 2021. "Cognition, Optimism, And The Formation Of Age‐Dependent Survival Beliefs," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 62(2), pages 887-918, May.
    11. Heiss, Florian & Hurd, Michael & van Rooij, Maarten & Rossmann, Tobias & Winter, Joachim, 2022. "Dynamics and heterogeneity of subjective stock market expectations," Journal of Econometrics, Elsevier, vol. 231(1), pages 213-231.
    12. Mary Riddel & David Hales, 2018. "Predicting Cancer‐Prevention Behavior: Disentangling the Effects of Risk Aversion and Risk Perceptions," Risk Analysis, John Wiley & Sons, vol. 38(10), pages 2161-2177, October.
    13. Wändi Bruine de Bruin & Katherine G. Carman, 2018. "Measuring Subjective Probabilities: The Effect of Response Mode on the Use of Focal Responses, Validity, and Respondents’ Evaluations," Risk Analysis, John Wiley & Sons, vol. 38(10), pages 2128-2143, October.
    14. Heiss, Florian & Hurd, Michael & Rossmann, Tobias & Winter, Joachim & van Rooij, Maarten, 2019. "Dynamics and Heterogeneity of Subjective Stock Market Expectations," Rationality and Competition Discussion Paper Series 157, CRC TRR 190 Rationality and Competition.
    15. Belot, Michèle & James, Jonathan & Spiteri, Jonathan, 2020. "Facilitating healthy dietary habits: An experiment with a low income population," European Economic Review, Elsevier, vol. 129(C).
    16. Wuppermann, Amelie Catherine, 2011. "Empirical Essays in Health and Education Economics," Munich Dissertations in Economics 13187, University of Munich, Department of Economics.
    17. Frank Sloan & Alyssa Platt, 2011. "Information, risk perceptions, and smoking choices of youth," Journal of Risk and Uncertainty, Springer, vol. 42(2), pages 161-193, April.
    18. Foster, Gigi & Frijters, Paul & Schaffner, Markus & Torgler, Benno, 2018. "Expectation formation in an evolving game of uncertainty: New experimental evidence," Journal of Economic Behavior & Organization, Elsevier, vol. 154(C), pages 379-405.
    19. Yiqun Chen & Frank Sloan, 2014. "Subjective Beliefs, Deterrence, and the Propensity to Drive While Intoxicated," NBER Working Papers 20680, National Bureau of Economic Research, Inc.
    20. Frank Sloan & Lindsey Eldred & Tong Guo & Yanzhi Xu, 2013. "Are people overoptimistic about the effects of heavy drinking?," Journal of Risk and Uncertainty, Springer, vol. 47(1), pages 93-127, August.

    More about this item

    Keywords

    subjective probabilities; beliefs; subjective expectations; health insurance; healthcare demand;
    All these keywords.

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • D84 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Expectations; Speculations
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    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:iza:izadps:dp13445. 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: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    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.