Incentives in Obesity and Health Insurance
The obesity rate in the United States has risen significantly in the past few decades. While a number of economic causes for the rise in obesity have been explored, little attention has been on the role of health insurance per se. This paper examines obesity in the context of a model where health insurance status can influence body weight. We attempt to isolate the effects of ex ante moral hazard, where people with health insurance may change their behaviors towards weight control. We use data from the Behavioral Risk Factor Surveillance System from 1993 to 2002 to determine the potential effect of having health insurance on measures of body weight. In our analyses, we control for a variety of confounding factors that may influence body weight and address the endogenous nature of health insurance. Our results show evidence that having insurance is associated with higher body mass (particularly for those above the poverty threshold) and an increased probability of being overweight. However, we find no evidence that having insurance affects the probability of being obese.
Published: Kelly, Inas Rashad; Markowitz, Sara. Incentives in Obesity and Health Insurance. Inquiry, 46(4): 418-432, Winter 2009.
This paper was revised on July 7, 2008