Social Interactions and the Health Insurance Choices of the Elderly: Evidence from the Health and Retirement Study

Using data from the 1998 Wave of the Health and Retirement Study, we examine the effect of social interactions on the health insurance choices of the elderly. We find that having more social interactions, as measured by contacts with friends and neighbors, reduces the likelihood of enrolling in a Medicare managed care plan relative to purchasing a medigap policy or having coverage through Medicare alone. Our estimates indicate that social networks are an important determinant of the health insurance choices of the elderly and provide suggestive evidence that "word-of-mouth" information sharing may have played a role in the preference of some seniors for traditional indemnity insurance over managed care.

[1]  J. Banthin,et al.  The demand for Medicare supplemental insurance benefits: the role of attitudes toward medical care and risk. , 1997, Inquiry : a journal of medical care organization, provision and financing.

[2]  M. Gold,et al.  Access to care in Medicare HMOs, 1996. , 1997, Health affairs.

[3]  J. Uhrig,et al.  Testing the Effect of Quality Reports on the Health Plan Choices of Medicare Beneficiaries , 2002, Inquiry : a journal of medical care organization, provision and financing.

[4]  Alan T. Sorensen.  Social Learning in the Demand for Employer-Sponsored Health Insurance , 2001 .

[5]  Miles S. Kimball,et al.  Preference Parameters and Behavioral Heterogeneity: An Experimental Approach in the Health and Retirement Survey , 1995 .

[6]  K. Crocker,et al.  The Efficiency Effects of Categorical Discrimination in the Insurance Industry , 1986, Journal of Political Economy.

[7]  M. Ingber,et al.  Satisfaction with care: do Medicare HMOs make a difference? , 1998, Health affairs.

[8]  W H Rogers,et al.  Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems. Results from the Medical Outcomes Study. , 1996, JAMA.

[9]  Arthur Snow,et al.  The efficiency of competitive equilibria in insurance markets with asymmetric information , 1985 .

[10]  C. Manski.  Identification of Endogenous Social Effects: The Reflection Problem , 1993 .

[11]  Mark S. Granovetter.  T H E S T R E N G T H O F WEAK TIES: A NETWORK THEORY REVISITED , 1983 .

[12]  D. Scanlon,et al.  Health plan report cards and insurance choice. , 1998, Inquiry : a journal of medical care organization, provision and financing.

[13]  Esther Duflo,et al.  Participation and Investment Decisions in a Retirement Plan: The Influence of Colleagues' Choices , 2000 .

[14]  D. Scanlon,et al.  HEDIS Measures and Managed Care Enrollment , 1999, Medical care research and review : MCRR.

[15]  E. Miller,et al.  Managed Care for Elderly People: A Compendium of Findings , 1998, American journal of medical quality : the official journal of the American College of Medical Quality.

[16]  Harold S Luft,et al.  HMO plan performance update: an analysis of the literature, 1997-2001. , 2002, Health affairs.

[17]  T. Rice,et al.  The impact of policy standardization on the Medigap market. , 1997, Inquiry : a journal of medical care organization, provision and financing.

[18]  Vistnes Jp,et al.  The demand for Medicare supplemental insurance benefits: the role of attitudes toward medical care and risk. , 1997 .

[19]  R H Miller,et al.  Does managed care lead to better or worse quality of care? , 1997, Health affairs.

[20]  Mark S. Granovetter.  The Strength of Weak Ties , 1973, American Journal of Sociology.