Institutional Affiliation: Center on Budget and Policy Priorities
|The RAND Health Insurance Experiment, Three Decades Later|
with Liran Einav, Amy Finkelstein: w18642
We re-present and re-examine the analysis from the famous RAND Health Insurance Experiment from the 1970s on the impact of consumer cost sharing in health insurance on medical spending. We begin by summarizing the experiment and its core findings in a manner that would be standard in the current age. We then examine potential threats to the validity of a causal interpretation of the experimental treatment effects stemming from different study participation and differential reporting of outcomes across treatment arms. Finally, we re-consider the famous RAND estimate that the elasticity of medical spending with respect to its out-of-pocket price is -0.2, emphasizing the challenges associated with summarizing the experimental treatment effects from non-linear health insurance contracts using ...
Published: Aviva Aron-Dine & Liran Einav & Amy Finkelstein, 2013. "The RAND Health Insurance Experiment, Three Decades Later," Journal of Economic Perspectives, American Economic Association, vol. 27(1), pages 197-222, Winter. citation courtesy of
|Moral Hazard in Health Insurance: How Important Is Forward Looking Behavior?|
with Liran Einav, Amy Finkelstein, Mark R. Cullen: w17802
We investigate whether individuals exhibit forward looking behavior in their response to the non-linear pricing common in health insurance contracts. Our empirical strategy exploits the fact that employees who join an employer-provided health insurance plan later in the calendar year face the same initial ("spot") price of medical care but a higher expected end-of-year ("future") price than employees who join the same plan earlier in the year. Our results reject the null of completely myopic behavior; medical utilization appears to respond to the future price, with a statistically significant elasticity of medical utilization with respect to the future price of -0.4 to -0.6. To try to quantify the extent of forward looking behavior, we develop a stylized dynamic model of individual behavio...
Published: “Selection on Moral Hazard in Health Insurance,” with Amy Finkelstein, Stephen Ryan, Paul Schrimpf, and Mark Cullen, American Economic Review, 103(1), 178-219, February 2013.