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      Switching Health Insurance Plans: Results from a Health Survey

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          Abstract

          The study is designed to provide an informal summary of what is known about consumer switching of health insurance plans and to contribute to knowledge about what motivates consumers who choose to switch health plans. Do consumers switch plans largely on the basis of critical reflection and assessment of information about the quality, and price? The literature suggests that switching is complicated, not always possible, and often overwhelming to consumers. Price does not always determine choice. Quality is very hard for consumers to understand. Results from a random sample survey ( n = 2791) of the Alkmaar region of the Netherlands are reported here. They suggest that rather than embracing the opportunity to be active critical consumers, individuals are more likely to avoid this role by handing this activity off to a group purchasing organization. There is little evidence that consumers switch plans on the basis of critical reflection and assessment of information about quality and price. The new data reported here confirm the importance of a group purchasing organizations. In a free-market-health insurance system confidence in purchasing groups may be more important for health insurance choice than health informatics. This is not what policy makers expected and might result a less efficient health insurance market system.

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          Most cited references45

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          The psychology of doing nothing: forms of decision avoidance result from reason and emotion.

          Several independent lines of research bear on the question of why individuals avoid decisions by postponing them, failing to act, or accepting the status quo. This review relates findings across several different disciplines and uncovers 4 decision avoidance effects that offer insight into this common but troubling behavior: choice deferral, status quo bias, omission bias, and inaction inertia. These findings are related by common antecedents and consequences in a rational-emotional model of the factors that predispose humans to do nothing. Prominent components of the model include cost-benefit calculations, anticipated regret, and selection difficulty. Other factors affecting decision avoidance through these key components, such as anticipatory negative emotions, decision strategies, counterfactual thinking, and preference uncertainty, are also discussed.
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            Consumer reports in health care: do they make a difference?

            The public release of health care-quality data into more formalized consumer health report cards is intended to educate consumers, improve quality of care, and increase competition in the marketplace The purpose of this review is to evaluate the evidence on the impact of consumer report cards on the behavior of consumers, providers, and purchasers. Studies were selected by conducting database searches in Medline and Healthstar to identify papers published since 1995 in peer-review journals pertaining to consumer report cards on health care. The evidence indicates that consumer report cards do not make a difference in decision making, improvement of quality, or competition. The research to date suggests that perhaps we need to rethink the entire endeavor of consumer report cards. Consumers desire information that is provider specific and may be more likely to use information on rates of errors and adverse outcomes. Purchasers may be in a better position to understand and use information about health plan quality to select high-quality plans to offer consumers and to design premium contributions to steer consumers, through price, to the highest-quality plans.
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              The Swiss health system: regulated competition without managed care.

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                Author and article information

                Contributors
                +31-243613077 , +31-243612379 , C.Lako@fm.ru.nl
                Journal
                Health Care Anal
                Health Care Analysis
                Springer US (Boston )
                1065-3058
                1573-3394
                18 July 2010
                18 July 2010
                December 2011
                : 19
                : 4
                : 312-328
                Affiliations
                [1 ]Department of Public Administration, Nijmegen School of Management, Radboud University Nijmegen, P.O. Box 9108, 6500 HK Nijmegen, The Netherlands
                [2 ]Management, Policy and Community Health, School of Public Health, University of Texas, Houston, TX USA
                [3 ]Center for Construction Research and Training, Silver Spring, MD USA
                Article
                154
                10.1007/s10728-010-0154-8
                3212687
                20640891
                e08a4d7b-1912-45c1-8023-b3d620d5f056
                © The Author(s) 2010
                History
                Categories
                Original Article
                Custom metadata
                © Springer Science+Business Media, LLC 2011

                Medicine
                purchasing groups,survey,health insurance,switching
                Medicine
                purchasing groups, survey, health insurance, switching

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