The influence of health care preferences on insurance enrollment and medical expenditure behaviors

Journal	Journal of Economic and Social Measurement
Publisher	IOS Press
ISSN	0747-9662 (Print) 1875-8932 (Online)
Subject	Business and Management, Economics and Econometrics, Statistics, Social Sciences, general and Management Science
Issue	Volume 38, Number 4 / 2013
Pages	325-345
DOI	10.3233/JEM-140381
Subject Group	Mathematics
Online Date	Thursday, April 24, 2014

Publisher's Copyright Statement

Study Examines How Consumer Attitudes Affect Health Insurance Enrollment and Medical Spending

Certain attitudes are likely to influence decisions about whether and when to use health care services, according to a study by AHRQ's Steven B. Cohen, Ph.D. The study examines the persistence of high levels of expenditures over time, the factors most likely to drive health care spending and the characteristics of individuals who incur high costs. Results were published online in the Journal of Economic and Social Measurement in an article, “The influence of health care preferences on insurance enrollment and medical expenditure behaviors.” Based on nationally representative longitudinal data from AHRQ’s Medical Expenditure Panel Survey, the study found that individuals who said they were healthy and did not need insurance coverage were substantially less likely to incur medical expenses relative to those who consistently disagreed with that classification. In addition, adults under age 65 who thought health coverage wasn’t worth the cost were three times more likely to remain uninsured, compared with those who disagreed.

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Authors

Steven B. Cohen¹

¹Center for Financing, Access and Cost Trends (CFACT), Agency for Healthcare Research and Quality, 540 Gaither Road John M. Eisenberg Building, Rockville, Maryland, 20850. Tel.: +301 427 1466; Fax: +301 427 1277; E-mail: scohen@ahrq.gov

Abstract

Individual attitudes and opinions may visibly impact upon an individual's decisions on how and when to use health care services and associated decisions with respect to medical expenditures. These health care preferences also serve as important inputs in helping to predict health insurance coverage take-up decisions. This paper considers the degree of concordance over time in health care attitudes regarding the need and value of health insurance coverage based on national data from the Medical Expenditure Panel Survey. It demonstrates that individuals who consistently indicated they were healthy and did not need coverage were substantially less likely to have a medical expense in both years, relative to their counterparts who consistently disagreed with that classification. The paper also finds that adults under the age of 65 who consistently indicated that health insurance was not worth the cost were at nearly three times as likely to be continuously uninsured relative to those who consistently disagreed.