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Record W4407375216 · doi:10.1002/mde.4502

Unraveling Spillovers on Health Insurance: The Impacts of Culture and Fraud on Health Insurance Coverage

2025· article· en· W4407375216 on OpenAlexaboutno aff
Rajeev K. Goel, James R. Jones, Michael A. Nelson

Bibliographic record

VenueManagerial and Decision Economics · 2025
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Systems and Reforms
Canadian institutionsnot available
Fundersnot available
KeywordsHealth insuranceBusinessActuarial scienceInsurance fraudEconomicsHealth careEconomic growth

Abstract

fetched live from OpenAlex

ABSTRACT This paper adds to the literature on the determinants of health insurance by focusing especially on the spillovers from culture and fraud, along with a set of “standard” determinants. The social aspects of culture and fraud could potentially increase or decrease the propensities of individuals to purchase health insurance, and our empirical analysis informs us in this regard. For this purpose, we employ data for the year 2017 (or the closest year available) across states in the United States for most variables in the model setup. To account for year‐to‐year variability in the size of the uninsured population and the fraud data, mean annual averages over the years 2017–2022 are used. Employing OLS estimation to cross‐sectional data, the results show that cultural tightness (denoting social/cultural cohesion, measured via an index) lowers the propensities to acquire health insurance, and greater fraud (i.e., fraud reports in a US state) also undermines health insurance coverage, albeit with relatively less statistical support. The impact of higher insurance premia depressing insurance coverage is found to be consistent with intuition. The scope of the government, via Medicaid expansion to provide health coverage to certain population groups, was relatively more effective in increasing insurance coverage than the sheer size of the government (i.e., total government spending). The proximity of a state to foreign borders (Canada and Mexico) did not matter. Other things being the same, states with larger land areas faced special challenges in providing health insurance coverage. The findings have importance for the formulation of policies in the public and private sectors, and especially flesh out the crucial, and largely neglected, influence of culture on health insurance purchases.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.711
Threshold uncertainty score0.615

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.018
GPT teacher head0.263
Teacher spread0.245 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designOther design
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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