In health insurance, voluntary deductibles are offered to the insured in return for a premium rebate. Previous research has shown that 11 % of the Dutch insured opted for a voluntary deductible (VD) in health insurance in 2014, while the highest VD level was financially profitable for almost 50 % of the population in retrospect. To explain this discrepancy, this paper identifies and discusses six potential determinants of the decision to opt for a VD from the behavioral economic literature: loss aversion, risk attitude, ambiguity aversion, debt aversion, omission bias, and liquidity constraints. Based on these determinants, five potential strategies are proposed to increase the number of insured opting for a VD. Presenting the VD as the default option and providing transparent information regarding the VD are the two most promising strategies. If, as a result of these strategies, more insured would opt for a VD, moral hazard would be reduced.

Behavioral economics, Health insurance, Moral hazard, Nudge theory, Prospect theory, Voluntary deductibles
dx.doi.org/10.1007/s10198-015-0745-2, hdl.handle.net/1765/81529
The European Journal of Health Economics
Erasmus School of Health Policy & Management (ESHPM)

Winssen, K.P.M, van, van Kleef, R.C, & van de Ven, W.P.M.M. (2016). Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?. The European Journal of Health Economics, 17(9), 1059–1072. doi:10.1007/s10198-015-0745-2