Why Do People Decline Free Preventive Health Care?
Posted: 17 Jun 2007
Date Written: June 2007
For many health conditions, the best treatment is prevention. To this end, many countries and insurers around the world encourage individuals to participate in preventive care. Citizens in the Netherlands are offered several preventive health care interventions free of charge, including flu shots, mammograms, and kidney checks. Despite little to no direct costs to the patient, many people fail to participate in these programs. The aim of this paper is to explain participation. Our primary data source is the CentERpanel, which contains rich information on socioeconomic variables, as well as (in an extra module) on health status and the use of preventive health care. The CentERpanel includes over 2000 Dutch households who participate in weekly internet surveys.
Similar to other future investments, there are many reasons why people may not participate in these programs. While for some people it is likely to be rational not to participate, many individuals who should rationally participate actually do not. However, myopia, cognitive biases and lack of information or understanding about the costs and benefits of these programs, may lead others to irrationally choose not to participate. Additionally, fear of unfavorable diagnoses, particularly cancer, often leads people to decline screening or medical treatment altogether. In vaccination programs, controversy about the effectiveness and possible negative side effects may play a role in the participation decision.
We empirically assess the importance of these different explanations, and investigate how they relate to socioeconomic characteristics of individuals and social interactions. We also consider the relationship with forward-looking choices such as savings and insurance, which may serve as indicator of individuals' discount rates. The paper contributes to a fuller understanding of participation decisions in preventive health care and to creating more effective preventive care programs in the future.
Keywords: Preventive Care
JEL Classification: D81, I12
Suggested Citation: Suggested Citation