Big Data = Big Trouble for Universal Healthcare? The Effects of Individualized Health Insurance on Solidarity

Abstract

The collection of Big Data and surging artificial intelligence (AI) technologies to analyze these data increasingly enable health insurers to calculate the individual health risks of their customers. By offering individualized rates, data-driven health insurance (HI) challenges fundamental norms of solidarity in universal healthcare systems. This paper investigates to what extent personal financial benefits of individualized HI, the associated privacy costs of mandatory data disclosure, and attitudinal healthcare solidarity affect people’s intention to switch to an individualized HI rate. Three pre-registered experiments with German respondents (Study 1: n = 162, Study 2: n = 439, Study 3: n = 1,621) suggest that financial incentives are highly effective in persuading citizens to switch to an individualized HI rate. The personal costs and people’s attitudinal healthcare solidarity do not moderate this positive relationship. As technological and demographic developments pressure current universal healthcare systems, the results raise important questions concerning the future of HI in increasingly digitalized societies and provide novel insights for healthcare practitioners, policy-makers, and researchers.

Marco Lünich

Social Scientist

I research public perceptions of artificial intelligence, the fairness and legitimacy of algorithmic decision-making, and the societal consequences of AI.