Hanoch Yaniv, Rice Thomas
University of California, Los Angeles, CA 90095-1772, USA.
Milbank Q. 2006;84(1):37-73. doi: 10.1111/j.1468-0009.2006.00438.x.
Herbert Simon's work on bounded rationality has had little impact on health policy discourse, despite numerous supportive findings. This is particularly surprising in regard to the elderly, a group marked by a decline in higher cognitive functions. Elders' cognitive capacity to make decisions will be challenged even further with the introduction of the new Medicare prescription drug benefit program, mainly because of the many options available. At the same time, a growing body of evidence points to the perils of having too many choices. By combining research from decision science, economics, and psychology, we highlight the potential problems with the expanding health insurance choices facing the elderly and conclude with some policy suggestions to alleviate the problem.
赫伯特·西蒙关于有限理性的研究,尽管有大量支持性研究结果,但对卫生政策讨论的影响甚微。这在老年人这一群体中尤其令人惊讶,因为他们的高级认知功能有所衰退。随着新的医疗保险处方药福利计划的推出,老年人的决策认知能力将面临更大挑战,主要原因是有众多选择。与此同时,越来越多的证据表明选择过多存在风险。通过整合决策科学、经济学和心理学的研究,我们强调了老年人面临的医疗保险选择不断增加所带来的潜在问题,并提出了一些缓解该问题的政策建议。