医疗账单冲击与不完全道德风险

中文摘要

消费者在接受医疗服务时对医疗价格较为敏感，但价格信息的延迟可能会扭曲道德风险。我们利用保险公司理赔处理时间的差异，研究在使用可比价医疗服务后，医疗账单如何影响家庭的溢出支出。家庭在接受预约服务后将支出增加22%，但在账单送达后又将支出减少11%。观察到的账单效应与价格不确定性的消除相一致；当定价信息尤为显著时，账单效应最强。一个纳入定价信息延迟的医疗服务需求模型表明，家庭在收到账单前会错误理解价格信号，而纠正这些认知可使年度平均（中位数）支出减少16%（7%）。

Abstract

Consumers are sensitive to medical prices when consuming care, but delays in price information may distort moral hazard. We study how medical bills affect household spillover spending following utilization of shoppable services, leveraging variation in insurer claim processing times. Households increase spending by 22% after a scheduled service, but then reduce spending by 11% after the bill arrives. Observed bill effects are consistent with resolving price uncertainty; bill effects are strongest when pricing information is particularly salient. A model of demand for healthcare with delayed pricing information suggests households misperceive pricing signals prior to bills, and that correcting these perceptions reduce average (median) spending by 16% (7%) annually.