what accounts for the changes in u s fiscal policy transmission using vector autoregressions on u s time series for 1957 79 and 1983 2004 we find government spending shocks to have stronger effects on output consumption and wages in the earlier period we try to account for this observation within a dsge model featuring price rigidities and limited asset market participation specifically we estimate the structural parameters of the model for both periods by matching impulse responses model based counterfactual experiments suggest that most of the changes in fiscal policy transmission are accounted for by increased asset market participation and the more active monetary policy of the volcker greenspan period

e ztax tax salience and tax rates this paper examines whether the salience of a tax system affects equilibrium tax rates i analyze how tolls change after toll facilities adopt electronic toll collection etc drivers are substantially less aware of tolls paid electronically i estimate that in steady state tolls are 20 to 40 percent higher than they would have been without etc consistent with a salience based explanation for this toll increase i find that under etc driving becomes less elastic with respect to the toll and toll setting becomes less sensitive to the electoral calendar alternative explanations appear unlikely to be able to explain the findings

do health plans risk select an audit study on germany s social health insurance abstract this paper evaluates whether health plans in germany s social health insurance select on an easily observable predictor of risk geography to identify plan behavior separately from concurrent demand side adverse selection i implement a double blind audit study in which plans are contacted by fictitious applicants from different locations i find that plans are less likely to respond and follow up with applicants from higher cost regions such as west germany the results suggest that supply side selection may emerge even in heavily regulated insurance markets the prospect of risk selection by firms has implications for studies of demand side selection and regulatory policy in these settings

health plan choice using a unique panel dataset of health plan choices and personal characteristics of employees at a single firm this paper provides estimates of price elasticities for health insurance plans in a managed competition setting estimated price elasticities are larger in absolute value than most previous estimates and the magnitude of the price elasticity suggests that there is a place for price competition in this market we also find evidence of transition costs in switching health plans for older and less healthy employees such differential responses to price may contribute to adverse selection in this market

managed competition and consumer price sensitivity in social health insurance this paper examines whether the introduction of managed competition in dutch social health insurance has resulted in effective price competition among insurance funds we find evidence of limited price competition which may be caused by low consumer price sensitivity using aggregate panel data from all insurance funds over the period 1996 1998 estimated premium elasticities of market share are 0 3 for compulsory coverage and 0 8 for supplementary coverage these elasticities are much smaller than in managed competition settings in us group insurance this may be explained by differences in switching experience and higher search costs associated with individual insurance

improving takeup of health insurance program a social experiment in france this paper is based on a randomised social experiment conducted in order to understand the low take up rate of a complementary health insurance voucher program for the poorest in france the aide complementaire sante acs we explore two of the main hypotheses put forward to explain low enrolment a lack of information about the program and a voucher amount considered to be too low a sample of eligible individuals living in an urban area in northern france were randomly split into three groups a control group who benefited from the standard level of financial aid a group benefiting from an increase in the value of the voucher and a third group benefiting from the same increase along with an invitation to an information meeting regarding acs we show that the voucher increase has a small but statistically significant effect on acs take up the invitation to the meeting appears to cancel out the positive effect of the voucher increase using an instrumental variable model to control for potential selection bias we find ambiguous evidence of the meeting attendance on acs take up this study confirms the difficulties that are faced in increasing the health insurance coverage of poor populations via subsidy programs

how individuals choose health insurance an experimental analysis an individual choosing a health insurance policy faces a complex decision environment where a large set of alternatives differ on a variety of dimensions there is uncertainty and the choice is repeated at least once a year we study decisions and decision strategies in a laboratory experiment where we create a controlled environment that closely mirrors this setting we use an electronic information board that allows to carefully monitor the individual s decision strategy the number of alternatives switching costs and the speed at which health deteriorates are varied across treatments we find that most subjects search is based more on attributes than on policies moreover we find that an increase in the number of alternatives increases decision making time makes subjects consider a lower fraction of the available information makes it more likely that subjects will switch and decreases the quality of their decisions the introduction of positive costs of switching makes people switch less often but improves the quality of their decisions finally if health deteriorates only gradually individuals tend to stick to their current policy too long

demand for health insurance marketplace plans was highly elastic in 2014 2015 abstract a major provision of the affordable care act was the creation of health insurance marketplaces which began operating for the 2014 plan year although enrollment initially grew in these markets enrollment has fallen recently amid insurer exits and rising premiums to better understand these markets we estimate premium elasticity of demand for marketplace plans using within plan premium changes from 2014 to 2015 accounting for state specific trends and simultaneous changes in generosity our preferred estimate implies that a one percent premium increase reduces plan specific enrollment by 1 7 percent we argue that this high elasticity reflects the rapid growth and high churn in this market as well as the high degree of standardization and the availability of many close substitutes

switching costs price sensitivity and health plan choice we investigate the extent to which sensitivity to health plan premiums differs across individuals according to characteristics related to the cost of switching plans our results indicate substantial variation in price sensitivity related to expected health care costs younger healthier employees are between two and four times more sensitive to price than employees who are older and who have been recently hospitalized or diagnosed with cancer we also find evidence of status quo bias estimated premium elasticities are significantly higher for new hires than for incumbent employees simulations combining our results with actuarial data illustrate the cost implications of risk related differences in price elasticity

public health insurance individual health and entry into self employment we investigate the impact of a differential treatment of paid employees versus self employed workers in a public health insurance system on the entry rate into self employment health insurance systems that distinguish between the two sectors of employment create incentives or disincentives to start a business for different individuals we estimate a discrete time hazard rate model of entry into self employment based on representative household panel data for germany which include individual health information the results indicate that an increase in the health insurance cost differential between self employed workers and paid employees by 10 per month decreases the probability of entry into self employment by 1 7 of the annual entry rate this shows that entrepreneurship lock which an emerging literature describes for the system of employer provided health insurance in the usa can also occur in a public health insurance system therefore entrepreneurial activity should be taken into account when discussing potential health care reforms

pricing and welfare in health plan choice premiums in health insurance markets frequently do not reflect individual differences in costs either because consumers have private information or because prices are not risk rated this creates inefficiencies when consumers self select into plans we develop a simple econometric model to study this problem and estimate it using data on small employers we find a welfare loss of 2 11 percent of coverage costs compared to what is feasible with risk rating only about one quarter of this is due to inefficiently chosen uniform contribution levels we also investigate the reclassification risk created by risk rating individual incremental premiums finding only a modest welfare cost

how sensitive are low income families to health plan prices as health care reform moves forward in the united states one common feature of virtually all proposals is to expand coverage for low income populations not through a traditional public insurance model but rather through a defined contribution exchange mechanism under this approach low income individuals would have a choice of a number of options for their insurance coverage individuals would receive a subsidy to purchase insurance that was tied to the lowest cost plan or some index of low cost plans and would pay some part of the difference if they chose a more expensive plan this major departure from the traditional free single choice public payer model raises a number of important questions but the key initial question is how price sensitive will lowincome consumers be in choosing across plans while there is now a sizable literature evaluating plan choice in the context of employerprovided insurance there are no previous studies of how these very low income populations will respond to choice in publicly financed insurance programs in this paper we study the plan choice of low income enrollees in massachusetts commonwealth care program that was established as part of the state s health reform in april 2006 enrollees in commonwealth care were given a choice of up to four medicaid managed the massachusetts health insurance experiment early experiences

clearing up the fiscal multiplier morass bayesian prior predictive analysis of five nested dsge models suggests that model specifications and prior distributions tightly circumscribe the range of possible government spending multipliers multipliers are decomposed into wealth and substitution effects yielding uniform comparisons across models by constraining the multiplier to tight ranges model and prior selections bias results revealing less about fiscal effects in data than about the lenses through which researchers choose to interpret data when monetary policy actively targets inflation output multipliers can exceed one but investment multipliers are likely to be negative passive monetary policy produces consistently strong multipliers for output consumption and investment

why does private consumption rise after a government spending shock recent empirical evidence suggests that private consumption is crowded in by government spending this outcome violates existing macroeconomic theory according to which the negative wealth effect brought about by a rise in public expenditure should decrease consumption

nudges at the dentist abstract we implement a field experiment to study the impact of reminder messages on dental health prevention patients who are due to schedule a check up receive no reminder a neutral reminder postcard or reminders including additional information on the benefits of prevention our results document a strong impact of reminders within one month after receiving a reminder the fraction of patients who make a check up appointment more than doubles the effect declines slightly over time but remains economically and statistically significant including additional information in the reminders does not significantly increase response rates relative to the neutral reminder finally our data indicates that applying reminders repeatedly neither strengthens nor weakens their effects

rule of thumb consumers meet sticky wages it has been argued that rule of thumb consumers substantially alter the determinacy properties of simple interest rate rules and the dynamics of an otherwise standard new keynesian model in this paper we show that nominal wage stickiness helps re establishing standard results key findings are that wage stickiness i affects the shape of determinacy regions in the parameters space restoring the relevance of the taylor principle for the conduct of monetary policy ii implies that a rise in consumption in response to an innovation in government spending is not a robust feature of the model

estimating price elasticities of convalescent care programmes this study is the first to estimate price elasticities of demand for convalescent care programmes in 1997 the german legislature more than doubled the daily co payments for the publicly insured from 6t o 13 the measure caused the overall demand for convalescent care treatments to fall by 20 to 25 i estimate the price elasticity for medical rehabilitation programmes aimed at preventing work disability to be about 0 3 whereas the elasticity for medical rehabilitation programmes for recovery from accidents at work lies around 0 5 the demand for preventive treatment at health spas is elastic and less than 1 how does the demand for medical care change when prices change since the early days of the profession of health economics the question of the price elasticity for health services has been central joseph p newhouse one of the founders of the field of health economics has published more than 100 articles alone on health care demand newhouse was also the leader of the rand group that designed and directed the famous rand health insurance experiment that focused on the impact of costsharing on the demand for medical care not only newhouse but also many other economists have devoted a great deal of attention to this topic

sinking swimming or learning to swim in medicare part d under medicare part d senior citizens choose prescription drug insurance offered by numerous private insurers we examine nonpoor enrollees actions in 2006 and 2007 using panel data our sample reduced overspending by 298 on average with gains by 81 percent of them the greatest improvements were by those who overspent most in 2006 and by those who switched plans decisions to switch depended on individuals overspending in 2006 and on individualspecific effects of changes in their current plans the oldest consumers and those initiating medications for alzheimer s disease improved by more than average suggesting that real world institutions help overcome cognitive limitations

does price framing affect the consumer price sensitivity of health plan choice this paper provides field evidence on how price framing affects consumers decision to switch health plans in 2009 german federal regulation required insurers to express premium differences between standardized health plans in absolute euro values relative to a federal reference price rather than in percentage point payroll tax differences representative individual level panel data and aggregated health plan level panel data on the universe of health plans show that the reform strongly increased enrollees willingness to switch plans with demand elasticities increasing fourfold the salience of premium differences and the default premium are obviously key driving forces in the decision to switch insurers

the effects of fiscal shocks on employment and the real wage we study the transmission of fiscal shocks in the labor market we employ a structural var and base identification on the restrictions that shocks to government consumption investment and employment must raise output and deficits these restrictions hold in both prototype real business cycle rbc and new keynesian models shocks to government consumption and investment increase real wages and employment contemporaneously both at state level and in the aggregate the dynamics in response to employment shocks are mixed increases in government employment raise the real wage and total employment in the aggregate however in one third of the states they reduce total employment

the macroeconomic effects of distortionary taxation abstract prescott 1986 estimates that technology shocks account for 75 of the fluctuations in the postwar u s economy this paper reestimates the contribution of technological change for a standard business cycle model that includes a public sector and fiscal disturbances i find that a significant fraction of the variance of aggregate consumption investment output capital stock and hours of work can be explained by disturbances in labor and capital tax rates and government consumption i also use the model to quantify the welfare costs of capital and labor taxation for both the time series and welfare calculations maximum likelihood estimates of taste technology and policy parameters are used

paying attention or paying too much in medicare part d we study whether people became less likely to switch medicare prescription drug plans pdps due to more options and more time in part d panel data for a random 20 percent sample of enrollees from 2006 2010 show that 50 percent were not in their original pdps by 2010 individuals switched pdps in response to higher costs of their status quo plans saving them money contrary to choice overload larger choice sets increased switching unless the additional plans were relatively expensive neither switching overall nor responsiveness to costs declined over time and above minimum spending in 2010 remained below the 2006 and 2007 levels

cellular service demand biased beliefs learning and bill shock by april 2013 the fcc s recent bill shock agreement with cellular carriers requires consumers be notied when exceeding usage allowances will the agreement help or hurt consumers to answer this question we estimate a model of consumer plan choice usage and learning using a panel of cellular bills our model predicts that the agreement will lower average consumer welfare by 2 per year because rms will respond by raising monthly fees our approach is based on novel evidence that consumers are inattentive to past usage meaning that bill shock alerts are informative and advances structural modeling of demand in situations where multipart taris induce marginal price uncertainty additionally our model estimates show that an

pricing regulation and imperfect competition on the massachusetts health insurance exchange abstract we analyze insurance pricing regulation under imperfect competition on the massachusetts health insurance exchange differential markups lead to price variation apart from cost variation coarse insurer pricing strategies identify consumer demand younger consumers are twice as price sensitive as older consumers older consumers thus face higher markups over costs modified community rating links prices for consumers differing in both costs and preferences and changes the marginal consumer firms face stricter regulations transfer resources from low cost to high cost consumers reduce firm profits and increase overall consumer surplus

reprint of the pros and cons of sick pay schemes testing for contagious presenteeism and noncontagious absenteeism behavior abstract this paper provides an analytical framework and uses data from the u s and germany to test for the existence of contagious presenteeism and negative externalities in sick leave insurance the first part exploits high frequency google flu data and the staggered implementation of u s sick pay mandates to show using a reduced form framework that population level influenza like disease rates decrease after employees gain access to paid sick leave next a simple theoretical framework provides evidence on the underlying behavioral labor supply mechanisms the model theoretically decomposes overall labor supply adjustments moral hazard into contagious presenteeism and noncontagious absenteeism behavior and derives testable conditions the last part illustrates how to implement the model exploiting a german sick pay reform and administrative industry level data on certified sick leave by diagnosis the empirical test finds that the labor supply elasticity for contagious diseases is significantly smaller than for noncontagious diseases under the identifying assumptions of the model this finding provides additional indirect evidence for the existence of contagious presenteeism

framing effects earnings expectations and the design of student loan repayment schemes abstract income driven student loan repayment idr plans provide protection against unaffordable loan payments and default by linking loan payments to borrower s earnings despite the advantages idr would offer to many borrowers take up remains low we use a survey experiment investigate how framing affects university of maryland undergraduates take up of idr in a set of hypothetical scenarios students are significantly more likely to choose idr when the insurance aspects of idr are emphasized and significantly less likely to do so when costs are emphasized idr framing interacts with expected labor market outcomes emphasizing the insurance aspects of idr has larger effects on students who anticipate a higher probability of nonemployment and or low earnings at graduation in contrast when costs are emphasized the choice of irdr is uncorrelated with students expected labor market outcomes simulation results suggest that a simple change in the framing of idr could generate substantial reductions in loan defaults with only small decreases in long run federal revenue

the pros and cons of sick pay schemes testing for contagious presenteeism and noncontagious absenteeism behavior abstract this paper provides an analytical framework and uses data from the u s and germany to test for the existence of contagious presenteeism and negative externalities in sick leave insurance the first part exploits high frequency google flu data and the staggered implementation of u s sick pay mandates to show using a reduced form framework that population level influenza like disease rates decrease after employees gain access to paid sick leave next a simple theoretical framework provides evidence on the underlying behavioral labor supply mechanisms the model theoretically decomposes overall labor supply adjustments moral hazard into contagious presenteeism and noncontagious absenteeism behavior and derives testable conditions the last part illustrates how to implement the model exploiting a german sick pay reform and administrative industry level data on certified sick leave by diagnosis the empirical test finds that the labor supply elasticity for contagious diseases is significantly smaller than for noncontagious diseases under the identifying assumptions of the model this finding provides additional indirect evidence for the existence of contagious presenteeism

choice price competition and complexity in markets for health insurance abstract the united states and other nations rely on consumer choice and price competition between competing health plans to allocate resources in the health sector while a great deal of research has examined the efficiency consequences of adverse selection in health insurance markets less attention has been devoted to other aspects of consumer choice the nation of switzerland offers a unique opportunity to study price competition in health insurance markets switzerland regulates health insurance markets with the aim of minimizing adverse selection and encouraging strong price competition we examine consumer responses to price differences in local markets and the degree of price variation in local markets using both survey data and observations on local markets we obtain evidence suggesting that as the number of choices offered to individuals grows their willingness to switch plans given a set of price dispersion differences declines which allows large price differences for relatively homogeneous products to persist we consider explanations for this phenomenon from economics and psychology

has fiscal policy helped stabilize the postwar u s economy abstract in this paper i consider whether postwar fiscal policy has helped stabilize the u s economy i do this by adding to the stochastic growth model fiscal policy feedback rules estimated from postwar data these rules allow fiscal policies to respond to current and lagged output and labor hours i use the estimated policy rules to see if postwar fiscal policy reduces output volatility and or lengthens expansions and shortens recessions i find that fiscal policy in general provides little stability on either count i also find that the endogenous feedback links by themselves can provide some stabilization

paying for health insurance the trade off between competition and adverse selection we use data on health plan choices by employees of harvard university to compare the benefits of insurance competition with the costs of adverse selection moving to a voucher type system induced significant adverse selection with a welfare loss of 2 to 4 percent of baseline spending but increased competition reduced harvard s premiums by 5 to 8 percent the premium reductions came from insurer profits so while harvard was better off the net effect for society was only the adverse selection loss adverse selection can be minimized by adjusting voucher amounts for individual risk we discuss how such a system would work governments are increasingly turning to market forces as a way to limit the cost of social insurance traditionally social insurance programs were operated as nonmarket goods governments mandated participation in a central program collected revenues to finance the program and ran the insurance system there was no role for competition among suppliers in providing the basic benefit as the costs of social insurance have increased however the centralized model of social insurance is coming under increasing strain in the united states for example recent proposals have called for replacing the medicare program with a health care voucher for the elderly aaron and reischauer 1995 cutler 1996 the voucher would guarantee people a basic insurance plan but the plans would be privately run competition among plans would generate plan premiums and enrollments similarly longstanding proposals for social security reform have called for replacing the current system with a system of individual accounts where people would make saving investment and annuitization decisions on their own advisory council on social security 1996 feldstein 1996 the trend is not just domestic in the united kingdom the national health service has moved to encourage more competition in recent years with the establishment of hospital trusts that bid for patients and partially fixed payments to physicians

paying medicare advantage plans to level or tilt the playing field medicare beneficiaries are eligible for health insurance through the public option of traditional medicare tm or may join a private medicare advantage ma plan both are highly subsidized but in different ways medicare pays for most of costs directly in tm and subsidizes ma plans based on a benchmark for each beneficiary choosing a private plan the level of this benchmark is arguably the most important policy decision medicare makes about the ma program many analysts recommend equalizing medicare s subsidy across the options referred to in policy circles as a level playing field this paper studies the normative question of how to set the level of the benchmark applying the versatile model developed by einav and finkelstein ef to medicare the ef framework implies unequal subsidies to counteract risk selection across plan types we also study other reasons to tilt the field the relative efficiency of ma vs tm market power of ma plans and institutional features of the way medicare determines subsidies and premiums after review of the empirical and policy literature we conclude that in areas where the ma market is competitive the benchmark should be set below average costs in tm but in areas characterized by imperfect competition in ma it should be raised in order to offset output enrollment restrictions by plans with market power we also recommend specific modifications of medicare rules to make demand for ma more price elastic

fiscal policy in general equilibrium this paper studies four classic fiscal policy experiments within a quantitatively restricted neoclassical model the authors main findings are as follows 1 permanent changes in government purchases can lead to short run and long run output multipliers that exceed one 2 permanent changes in government purchases induce larger effects than temporary changes 3 the financing decision is quantitatively more important than the resource cost of changes in government purchases and 4 public investment has dramatic effects on private output and investment these findings stem from important dynamic interactions of capital and labor absent in earlier equilibrium analyses of fiscal policy copyright 1993 by american economic association

choice inconsistencies among the elderly evidence from plan choice in the medicare part d program we evaluate the choices of elders across their insurance options under the medicare part d prescription drug plan using a unique data set of prescription drug claims matched to information on the characteristics of choice sets we document that elders place much more weight on plan premiums than on expected out of pocket costs value plan financial characteristics beyond any impacts on their own financial expenses or risk and place almost no value on variance reducing aspects of plans partial equilibrium welfare analysis implies that welfare would have been 27 higher if patients had all chosen rationally

insurer pricing and consumer welfare evidence from medigap this article examines the welfare impact of imperfect competition in the medicare supplement insurance medigap market two firms control nearly three fourths of the medigap market and premiums exceed claims by over 25 i find that a low price elasticity and consumers brand preferences lead firms to engage in substantial marketing and price above cost therefore the strategic behavior of insurers facing relatively inelastic demand is critical in explaining poor market performance i also find that insurers do not capture all of the rents in this market rents also accrue to actors who perform marketing functions including agents and brokers

consumer inertia choice dependence and learning from experience in a repeated decision problem abstract understanding when and how individuals think about real life problems is a central question in economics this paper studies the role of inertia inattention state dependence and learning the empirical setting is a tariff experiment when optional measured tariffs for local telephone calls were introduced unanticipatedly we find that consumers tend to align their choices of tariff and telephone use levels correctly despite low potential savings mistakes are not permanent as individuals actively engage in tariff switching in order to reduce the monthly cost of telephone service ignoring unobservable heterogeneity and the endogeneity of past choices would have reversed these results

adverse selection and inertia in health insurance markets when nudging hurts this paper investigates consumer inertia in health insurance markets where adverse selection is a potential concern we leverage a major change to insurance provision that occurred at a large firm to identify substantial inertia and develop and estimate a choice model that also quantifies risk preferences and ex ante health risk we use these estimates to study the impact of policies that nudge consumers toward better decisions by reducing inertia when aggregated these improved individual level choices substantially exacerbate adverse selection in our setting leading to an overall reduction in welfare that doubles the existing welfare loss from adverse selection jel d82 g22 i13 a number of potential impediments stand in the way of efficient health insur ance markets the most noted of these is adverse selection first studied by akerlof 1970 and rothschild and stiglitz 1976 in insurance markets prices reflect the expected risk costs of the insured pool whether the reason is price regulation or private information when insurers cannot price all risk characteristics riskier consumers choose more comprehensive health plans this causes the equilibrium prices of these plans to rise and healthier enrollees to select less comprehensive coverage than they would otherwise prefer

using incentives to encourage healthy eating in children there is growing interest in the situations in which incentives have a significant effect on positive behaviors particularly in children using a randomized field experiment we find that incentives increase the fraction of children eating a serving of fruits or vegetables during lunch by 80 percent and reduce the amount of waste by 33 percent at schools with a larger fraction of low income children the increase in the fraction of children who eat a serving of fruits or vegetables is even larger indicating that incentives successfully target the children who are likely to benefit the most from the increased consumption

price and the health plan choices of retirees abstract this study analyzes health plan choices of retirees in an employer sponsored health benefits program that resembles premium support models proposed for medicare in this program out of pocket premiums depend on when an individual retired and his or her years of service as of that date since this price variation is exogenous to unobserved plan attributes and retiree characteristics it is possible to obtain unbiased premium elasticity estimates the results indicate a significantly negative effect of premiums the implied elasticities are at the low end of the range found in previous studies on active employees

habit formation in consumption a meta analysis abstract we examine 597 estimates of habit formation reported in 81 published studies the mean reported strength of habit formation equals 0 4 but the estimates vary widely both within and across studies we use bayesian and frequentist model averaging to assign a pattern to this variance while taking into account model uncertainty studies employing macro data report consistently larger estimates than micro studies 0 6 vs 0 1 on average the difference remains 0 5 when we control for 30 factors that reflect the context in which researchers obtain their estimates such as data frequency geographical coverage variable definition estimation approach and publication characteristics we also find that evidence for habits strengthens when researchers use lower data frequencies employ log linear approximation of the euler equation and utilize open economy dsge models moreover estimates of habits differ systematically across countries

heuristic thinking and limited attention in the car market can heuristic information processing affect important product markets analyzing over 22 million wholesale used car transactions we find evidence of left digit bias in the processing of odometer values whereby individuals focus on the number s leftmost digits the bias leads to discontinuous drops in sale prices at 10 000 mile odometer thresholds along with smaller drops at 1 000 mile thresholds these findings reveal that information processing heuristics matter even in markets with large stakes and easily observed information we model left digit bias in an inattention framework and structurally estimate the inattention parameter empirical patterns suggest the results are driven by final customers rather than professional agents jel d12 d44 d83 l81

higher order risk attitudes demographics and financial decisions we conduct an experiment to study the prevalence of the higher order risk attitudes of prudence and temperance in a large demographically representative sample as well as in a sample of undergraduate students participants make pairwise choices between lotteries of the form proposed by eeckhoudt and schlesinger 2006 the choices in these lotteries isolate prudent from imprudent and temperate from intemperate behavior we relate individuals risk aversion prudence and temperance levels to demographics and financial decisions we observe that the majority of individuals decisions are consistent with risk aversion prudence and temperance in both the student and the demographically representative sample an individual s level of prudence is predictive of his wealth saving and borrowing behavior outside of the experiment while temperance predicts the riskiness of portfolio choices our findings suggest that the coefficient of relative prudence for a representative individual is approximately equal to two

the effect of price on switching among health plans a recent policy change by the university of california uc provides a unique natural experiment for investigating the sensitivity of consumers to health plan premiums when the uc moved to a policy of limiting its contribution to the cost of the least expensive plan out of pocket premiums increased for roughly one third of uc employees we examine the extent to which uc employees switched plans in response to this change in premiums our results indicate a strong response individuals facing premium increases of less than 10 were roughly 5 times as likely to switch plans as those whose premiums remained constant

premium levels and demand response in health insurance relative thinking and zero price effects abstract in health care systems with a competitive health insurance market governments or other sponsors e g employers often subsidize premiums to encourage enrolment these subsidies are typically independent of plan choice leaving the absolute premium differences in place so as not to distort consumer choice of plan such subsidies do however change the relative premium differences across plans which according to theories from behavioral economics can affect choice consumers might be sensitive to differences relative to a reference premium relative thinking furthermore consumers might be particularly sensitive to a reference premium of zero zero price effect a relevant range for some subsidized health insurance markets this paper tests these ideas with two sources of evidence we argue that observed equilibria in germany and the u s medicare advantage markets are consistent with a powerful zero price effect resulting in an equilibrium focal pricing at zero this contrasts with the netherlands where equilibrium premiums are well above zero in an empirical test using hypothetical questions in a web based survey in these three countries we also find evidence for both a relative thinking and a zero price effect in the demand for health insurance our findings imply that well designed subsidies can leverage relative thinking to increase demand elasticity for health plans creation of a powerful reference price e g at zero however risks subverting price competition