Estructura del COSTO TOTAL (CD+CI) según servicios finales que lo conforman

Table IV.7 presents the generalized ordered logit regression results for Model III in table IV.5.1. There are two sets of regression results reported by the generalized ordered logit. Panel 1 shows the regression results for the combined bundle II and bundle III versus bundle I. Panel 2 presents the results for bundle III versus the combination of bundle I and bundle II. These two pairs of comparisons can both be well perceived as “the more complete bundle choice” versus “the less complete bundle choice.”

The generalized ordered logit first tests the proportional odds assumption. The test results indicate that the model does not violate the proportional odds/parallel lines assumption because the violated variables had been auto-fitted (chi2=21.23, p>chi2=0.4447).

The heterogeneous effects of past bundle choice and whether the premium is subsidized are reported in two panels. It clearly shows that the past choice of bundle II has opposite effects in these two pairs of comparisons. In panel 1, those who purchased bundle II are 9.75 times more likely to choose the more complete bundles (bundle III and II) compared to those who purchased bundle I, while in panel 2 they are 0.18 times less likely to purchase the more complete bundle choice (bundle III only) compared with those who purchased bundle I in the past. The effect of past choice, bundle III, is found the same for the two comparisons: individuals who purchased bundle III in the past are

19.54 times more likely to choose the more complete bundle choice compared with those who purchased bundle I.

This discrepancy in past choices of bundle II actually makes intuitive sense. It shows consumers’ intention to stay with their past choices. The past bundle II customers tend to choose the more complete bundle when current choice of bundle II is grouped in a more complete bundle choice, while they tend to choose the less complete bundle when current bundle II is grouped in a less complete bundle choice. It seems that the choice of bundle II dominates. However, the magnitude of odds ratios suggests that, after all, people would like to purchase a more complete bundle (OR=9.75 v. OR=0.18, chi- sq=267.78, p<.001).

A one thousand dollars increase in enrollee premium decreases the odds of purchasing a more complete bundle choice by 28%. Consumers with a subsidized health insurance premium are more likely to buy a more complete coverage bundle. When bundle II is included in the more complete bundle choice, individuals are more likely to purchase a more complete coverage bundle compared to bundle III only (OR=1.76 v. OR=1.32, chi-sq=7.78, p=0.005). This indicates that bundle II is more attractive than bundle III to consumers when making a decision to purchase the more complete coverage bundle. It might be because bundle II is more cost efficient even though bundle III is the most prevalent choice (53%).

Table IV.7 also shows that individuals who are employed are 1.35 times more likely to purchase a more complete coverage bundle compared with those who are not employed (OR=1.35, 95% CI=[1.12 – 1.62]). It is obvious that the coverage options are more available and more affordable for the employed.

Having dependents is one of the most important reasons for consumers to buy health insurance and is directly related to the choice of coverage options. The results indicate that those who have any dependent are 1.30 times more likely to buy a more complete coverage bundle compared with those who do not have any dependents (OR=1.30, 95% CI [1.11 – 1.53], p=0.001).

Studies show that income has been the most important financial indicator for consumer purchasing behaviors. After controlling for other covariates, consumers who have higher income are more likely to purchase more complete coverage bundles compared with low-income consumers. It is interesting to note that, in this study, the middle-income individuals are even a little more likely to buy more the complete coverage bundle compared with the high-income individuals (OR=1.36 v. OR=1.19). This may be because the high-income individuals would rather buy relatively more expensive but independent dental or vision insurance not offered by their major health plans controlling for other plan and individual characteristics.

choices (OR=0.72, 95% CI=[0.52 – 1.02], p=0.066); a one thousand dollar increase in enrollee premium will decrease the odds of choosing the more complete coverage bundle by 28%. However, the effect is significant only at the 10% confidence level. The bundle choice does not seem related to plan type (OR=0.98, 95% CI=[0.86 – 1.11], p=0.725). This is consistent with the hypotheses that the coverage bundle choice within a plan is not price sensitive but more sensitive to individual valuations.

Above all, we can conclude that, first, individuals making choice of health plans and making choice of coverage bundles within the enrolled plans are two distinct sets of decision-making, and that consumers make the decisions with different strategies. Once enrolled in a plan, plan price and plan type do not appear relevant to coverage bundle choice, whereas contemporaneous employment status, income levels, premium subsidy, and dependents play more important roles. Plan ratings as perceived plan quality play a persistently significant role in explaining consumers’ coverage bundle choice. The effects of past bundle choice indicate strong evidence of inertia.