October 17, 2007 - Losing money feels worse, dollar for dollar, than gaining money feels good. That's the conclusion of researchers at Princeton University's Institute for Advanced Studies who, in conjunction with Survey Sampling International (SSI), recently conducted a health care plan study. The survey found that people like to pay a standard monthly fee and co-pays for preventive tests when they are reimbursed for taking the tests.

SSI, recommended by the Princeton Survey Research Center as their preferred provider, conducted an online survey of 1,000 U.S. respondents in June 2007. Participants were randomly assigned to two groups - half were asked to review a "prepay" plan and half were asked to review a "payback" plan. Princeton researchers Dan Ariely and Janet Schwartz chose SSI to conduct this breakthrough study based on their previous experiences with the company.

"It was really a very simple decision," explains Schwartz. "Dan and I independently had good experiences getting our desired sample quickly from SSI. The tech support at SSI was very helpful in terms of the interface with our survey software and that was in addition to monitoring the study from beginning to end. Our specifications for the sample were that respondents are over the age of 18 and that 50% are male."

One group of respondents was asked to compare a "standard" insurance plan, where the insured pays a monthly fee and co-pays for tests, visits to the doctor, etc., with a payback plan where the insured pays a higher monthly fee and the insurance company pays the insured to get important health tests and screenings. The survey revealed that 58% preferred the standard plan and 42% preferred the payback plan.

The other group of respondents was asked to compare the standard plan with a prepay plan where participants pay the same monthly fee but they also prepay the co-pays for routine tests, screenings, etc. If they go to their health care appointments, they are reimbursed; if they don't, the money is forfeited. In this survey, 44% preferred the standard plan and 56% preferred the prepay plan.

"This suggests to us that people like the element of self-control," Schwartz notes. "Payback is nice and reduces some of the negative emotion produced by having to pay for things that are unpleasant, but it's not really enough to make the plan more attractive than the standard plan. Pre-payment confronts two issues: one, that people shouldn't have to add the "pain" of financial loss to the discomfort of having tests; and two, that the prepay plan addresses the issue of self-control. 'If I don't go for my mammogram, I lose $50.'"

The fact that people preferred the prepay plan over the payback plan "is a very interesting finding," says Schwartz. "It suggests that people are more attracted to plans that will motivate behavioral change and self-control than to pure economic incentives to engage in routine preventive care."

Ariely adds: "People have self-control problems. They want to do things that are good for them - like dieting, going to the gym, or saving money - but they have a hard time executing their ideals. However, when people procrastinate on preventive health care, they sometimes suffer grave consequences."

"We wanted to see if people would be willing to sacrifice money to gain control over their lives," Ariely continues. "Would they be willing to pre-pay $250 for a colonoscopy and get the money back if they show up on time for the procedure? They are risking losing the money by pre-paying. We wondered if pre-paying could motivate people to get the preventive care."

Survey Sampling is fielding additional rounds of the study to help determine the optimal alternative health care plan. Ariely says he plans to take the "best" plan to a small company that pays for employees' health care but does not do so through a health care organization.

"We will ask them to implement this program for one year," Ariely points out. "Based on that outcome, we will approach health care providers."

About Survey Sampling International

Survey Sampling International is the premier global provider of sampling solutions. SSI offers access to consumer and business-to-business respondents via Internet, telephone and other means; survey programming and hosting services; and survey consultation. SSI is the supplier of choice for more than 1,800 marketing researchers, including 46 of the top 50 marketing research firms.

SSI manages Internet panels in 19 countries, offers Internet respondent access in more than 50 countries, random digit dialing in 21 countries, and both demographic and geographic targeting assistance. SSI's proprietary global panels provide access to more than 3.8 million engaged respondents representing nearly 8 million household members.

Founded in 1977, SSI has an international staff of more than 300 representing 19 countries and 25 languages.

Respondents were asked to rate the attractiveness of the following
Health Care Insurance Plans

*Prepaid fees are returned when the insured keeps an appointment and/or picks up a prescription on time; otherwise, the fees are forfeited.