Department of Economics, Massachusetts Institute of Technology, Cambridge MA 02139.
Am Econ Rev. 2011 May;101(3):377-381. doi: 10.1257/aer.101.3.377.
This paper investigates the degree to which choice inconsistencies documented in the context of Medicare Part D plan choice vary across consumers and geographic regions. Our main finding is that there is surprisingly little variation: regardless of age, gender, predicted drug expenditures or the predictability of drug demand consumers underweight out of pocket costs relative to premiums and fail to consider the individualized consequences of plan characteristics; as a result, they frequently choose plans which are dominated in the sense that an alternative plan provides better risk protection at a lower cost. We find limited evidence that the sickest individuals had more difficulty with plan choice, and we document that much of the variation in potential cost savings across states comes from variation in choice sets, not variation in consumers' ability to choose.
本文研究了医疗保险 D 部分计划选择中记录的选择不一致程度在消费者和地理区域之间的差异。我们的主要发现是,差异惊人地小:无论年龄、性别、预测的药物支出或药物需求的可预测性如何,消费者都低估了自付费用相对于保费的重要性,并且没有考虑到计划特征的个体化后果;因此,他们经常选择那些从本质上处于劣势的计划,因为替代计划以更低的成本提供更好的风险保护。我们发现,证据有限表明病情最严重的个体在计划选择方面有更多困难,并且我们记录了各州潜在成本节约的大部分差异来自选择集的差异,而不是消费者选择能力的差异。