Brot-Goldberg Zarek, Layton Timothy, Vabson Boris, Wang Adelina Yanyue
University of Chicago.
Harvard University and NBER.
Am Econ Rev. 2023 Oct;113(10):2718-2758. doi: 10.1257/aer.20210013.
We show in two natural experiments that default rules in Medicare Part D have large, persistent effects on enrollment and drug utilization of low-income beneficiaries. The implications of this phenomenon for welfare and optimal policy depend on the sensitivity of passivity to the value of the default option. Using random assignment to default options, we show that beneficiary passivity is extremely insensitive, even when enrolling in the default option would result in substantial drug consumption losses. A third natural experiment suggests that variation in active choice is driven by random transitory shocks rather than the inherent attentiveness of some beneficiaries.
我们在两项自然实验中表明，医疗保险D部分的默认规则对低收入受益人的参保和药物使用有巨大且持久的影响。这一现象对福利和最优政策的影响取决于被动性对默认选项价值的敏感度。通过对默认选项进行随机分配，我们发现即使选择默认选项会导致大量药物消费损失，受益人也极其不敏感。第三个自然实验表明，主动选择的差异是由随机的短暂冲击驱动的，而不是某些受益人的固有注意力。
