Information on Cancer Prevalence and Oncologic Insurance Take-up

Caceres, Daniela and Valdivia, Melissa and Barron, Manuel (2024): Information on Cancer Prevalence and Oncologic Insurance Take-up. Forthcoming in: Economics Bulletin

Abstract

We study whether oncological insurance demand can be boosted by providing information on the likelihood of developing cancer at some point over the consumer’s lifetime. We conducted a lab- in-the-field hypothetical choice experiment on oncological insurance with adults aged 40-68 of middle to high socioeconomic status in Lima, Peru. A random subset of participants received information on the likelihood of developing cancer before the age of 75. Participants were offered partial and full insurance options. Information increased take-up for full insurance by 18 percentage points (33% of the control group rate) but did not affect demand for partial insurance. Treatment effect arose mostly from participants who do not live with an oncology patient at home, but are roughly constant by education, sex, and age. Our stylized model suggests that this effect is driven by consumers with low present bias. Our findings suggest that in developing countries, where information about the probability of developing cancer during one’s lifetime is not widely known, providing this information can boost demand for insurance, but that present- bias can hinder this effect.

• Item Type: MPRA Paper
• Language: English
• Keywords: oncologic insurance; insurance take-up; present bias; lab-in-the-field
• Subjects: D - Microeconomics > D9 - Intertemporal Choice > D91 - Intertemporal Household Choice ; Life Cycle Models and Saving; I - Health, Education, and Welfare > I1 - Health > I13 - Health Insurance, Public and Private; O - Economic Development, Innovation, Technological Change, and Growth > O1 - Economic Development > O12 - Microeconomic Analyses of Economic Development

References

AARP. (2018). The High Cost of Cancer Treatment. AARP The Magazine. Available from: https://www.aarp.org/money/credit-loans-debt/info-2018/the-high-cost-of-cancer-treatment.html, accessed [10 August 2021].

Abaluck, J. T. & Gruber, J. (2011). Choice inconsistencies among the elderly: evidence from plan choice in the Medicare Part D program. American Economic Review 101, 1180–1210.

Aizer, A. (2007). Public Health Insurance, Program Take-Up, and Child Health. The Review of Economics and Statistics 89, 400–415.

Baicker, K., Congdon, W. J. & Mullainathan, S. (2012). Health insurance coverage and take-up: lessons from behavioral economics. Milbank Quarterly, 90, 107-134

Barseghyan, Levon, Francesca Molinari, Ted O’Donoghue, and Joshua C. Teitelbaum. 2013. “The Nature of Risk Preferences: Evidence from Insurance Choices.” American Economic Review 103 (6): 2499–2529.

Belissa, T. K., Lensink, R., & Van Asseldonk, M. (2020). Risk and ambiguity aversion behavior in index-based insurance uptake decisions: Experimental evidence from Ethiopia. Journal of Economic Behavior & Organization, 180, 718-730.

Saurabh Bhargava, George Loewenstein, Justin Sydnor Choose to Lose: Health Plan Choices from a Menu with Dominated Option The Quarterly Journal of Economics, Volume 132, Issue 3, August 2017, Pages 1319–1372, https://doi.org/10.1093/qje/qjx011

Bryan, G. (2019). Ambiguity aversion decreases the impact of partial insurance: Evidence from African farmers. Journal of the European Economic Association, 17(5), 1428-1469.

CarminatiL. (2020).Behavioural Economics and Human Decision Making: Instances from the Health Care System. Health policy.

Carter, M., de Janvry, A., Sadoulet, E., & Sarris, A. (2017). Index insurance for developing country agriculture: a reassessment. Annual Review of Resource Economics, 9, 421-438.

Cole, Shawn, Xavier Giné, Jeremy Tobacman, Petia Topalova, Robert Townsend, and James Vickery. 2013. "Barriers to Household Risk Management: Evidence from India." American Economic Journal: Applied Economics, 5 (1): 104-35.

Collins, Sara, Herman K. Bhupal and Michelle M. Doty. 2019. Health Insurance Coverage Eight Years After the ACA: Fewer Uninsured Americans and Shorter Coverage Gaps, But More Underinsured. Commonwealth Fund, Feb.

Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2020). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today, accessed [10 August 2021].

Giné, X., & Yang, D. (2009). Insurance, credit, and technology adoption: Field experimental evidencefrom Malawi. Journal of development Economics, 89(1), 1-11.

Handel, Benjamin R., and Jonathan T. Kolstad. 2015. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare." American Economic Review, 105 (8): 2449-2500.

Handel, B. R., Kolstad, J. T., & Spinnewijn, J. (2019). Information frictions and adverse selection: Policy interventions in health insurance markets. Review of Economics and Statistics, 101(2), 326-340.

Heiss H., Leive A., McFadden D., Winter J. (2013). Plan selection in Medicare Part D: evidence from administrative data. Journal of Health Economics 32, 1325-1344

Hill, R. V., & Robles, M. (2011). Flexible insurance for heterogeneous farmers: results from a small-scale pilot in Ethiopia. IFPRI-Discussion Papers, (1092).

Instituto Nacional de Estadística e Informática (INEI) (2018). Población afiliada a algún seguro de salud sobre la base de los resultados de los Censos Nacionales 2017: XII de Población, VII de Vivienda, III de Poblaciones Indíginenas. Lima: INEI.

Kenney, G. M., Cook, A., & Dubay, L. (2009). Progress enrolling children in Medicaid/CHIP: who is left and what are the prospects for covering more children?. Washington (DC): Urban Institute.

Jeffrey R. Kling, Sendhil Mullainathan, Eldar Shafir, Lee C. Vermeulen, Marian V. Wrobel. (2012) Comparison Friction: Experimental Evidence from Medicare Drug Plans. The Quarterly Journal of Economics, Volume 127, Issue 1, February 2012, Pages 199–235, https://doi.org/10.1093/qje/qjr055

Kremer, M., Rao, G., & Schilbach, F. (2019). Behavioral development economics. In Handbook of Behavioral Economics: Applications and Foundations 1 (Vol. 2, pp. 345-458). North-Holland.

Polyakova, Maria, “Regulation of Insurance with Adverse Selection and Switching Costs: Evidence from Medicare Part D,” American Economic Journal: Applied Economics 8:3 (2016), 165–195.

Rice, T. (2013). The behavioral economics of health and health care. Annual Review of Public Health, 34, 431-447

Serfilippi, E., Carter, M., & Guirkinger, C. (2019). Insurance contracts when individuals “greatly value” certainty: Results from a field experiment in Burkina Faso. Journal of Economic Behavior & Organization. doi:10.1016/j.jebo.2019.07.017

Shapira & Venezia (2008). On the preference for full-coverage policies: Why do people buy too much insurance? Journal of Economic Psychology, 29, 747–761.

Sydnor (2010). (Over) insuring Modest Risks. American Economic Journal: Applied Economics 2 (October 2010): 177–199.