健康保险和事前道德风险:来自医疗保险的证据。

Dhaval Dave, Robert Kaestner
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引用次数: 229

摘要

基本经济理论表明,医疗保险的覆盖范围可能导致预防活动的减少,但实证研究尚未提供很多证据来支持这一预测。然而,在涉及不良健康事件的其他保险情况下,事前道德风险的证据更为一致。在本文中,我们扩展了健康保险对健康行为影响的分析,允许健康保险对健康行为有直接(事前道德风险)和间接影响的可能性。间接影响是通过健康促进信息的变化和疾病的可能性产生的,这可能是保险引起的与医疗专业人员更多接触的副产品。我们确定了这两种效应,并在此过程中确定了纯粹的事前道德风险效应。这项研究利用了在65岁时获得医疗保险覆盖的健康保险的合理外生变化。我们发现有证据表明,获得健康保险会减少老年男性的预防,并增加不健康行为。我们还发现有证据表明,医生咨询在改变健康行为方面是成功的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health insurance and ex ante moral hazard: evidence from Medicare.

Basic economic theory suggests that health insurance coverage may cause a reduction in prevention activities, but empirical studies have yet to provide much evidence to support this prediction. However, in other insurance contexts that involve adverse health events, evidence of ex ante moral hazard is more consistent. In this paper, we extend the analysis of the effect of health insurance on health behaviors by allowing for the possibility that health insurance has a direct (ex ante moral hazard) and indirect effect on health behaviors. The indirect effect works through changes in health promotion information and the probability of illness that may be a byproduct of insurance-induced greater contact with medical professionals. We identify these two effects and in doing so identify the pure ex ante moral hazard effect. This study exploits the plausibly exogenous variation in health insurance as a result of obtaining Medicare coverage at age 65. We find evidence that obtaining health insurance reduces prevention and increases unhealthy behaviors among elderly men. We also find evidence that physician counseling is successful in changing health behaviors.

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