Victoria Marone Publications

Health insurance lowers the out-of-pocket price of healthcare, and it is well-established that this leads to higher utilization of care. This manifestation of “moral hazard” is typ ically viewed as a social cost of insurance. Within a standard model, this paper shows that a consumer’s ability to change her behavior in response to insurance can also play a central role in the ability of insurance to protect her from risk. We provide a theoretical characterization of this channel and quantify its importance empirically. Under stan dard parameterizations and estimates in the literature, we find that insurance-induced healthcare utilization can account for more than half of the total value of risk protection derived from insurance. Preventing consumers from changing their behavior would lower healthcare spending, but also result in a major loss of risk protection, on-net reducing social welfare in some cases. Our results suggest that under-utilization of healthcare may thus be an equally important threat to welfare as over-utilization.

We analyze a multidimensional screening model in which a principal offers a menu of quality-price pairs to a consumer with multiple dimensions of private information and a quasilinear utility function. We derive necessary conditions for optimality, and use them to provide insight into optimal exclusion, positive trade, and screening. We then recast the problem in terms of incremental quality levels and prices, the so-called demand-profile approach (DPA). Under DPA, the problem decouples across increments and can be solved one at a time. We provide novel conditions under which DPA recovers the solution to the full problem exactly or approximately, and which make the necessary conditions sufficient for optimality: essentially, valuations must be sufficiently correlated across quality increments. Applied to empirical estimates of demand for health insurance, we show that DPA is approximately valid, and we apply it to understand equilibrium outcomes in a monopoly insurance market.