Department of Consumer Protection

Abstract Flooding is the most common and costly natural disaster, with losses escalating due to climate change. For millions of US homes exposed to flood risk, property‐level investments in flood resilience offer an attractive strategy to manage losses. But financing such investments remains a challenge. One option is to harness insurance. We use field data of residential flood insurance purchases from a private insurer that offered a supplemental policy (FloodReady) to cover the costs of rebuilding with flood‐resilient materials. We exploit a change in the default purchase option to estimate how default enrollment in FloodReady influences take‐up. We estimate that autoenrollment increases take‐up from 12% to 32%. This dramatic increase suggests that behavioral interventions can be used to improve the financial capacity of homeowners to reduce future flood losses. That said, the fact that most policyholders still actively opt‐out even under autoenrollments indicates the limits of default effects in this context. We discuss potential moderators and implications for default effects across settings.

The Behavioral Life‐Cycle hypothesis (Thaler & Shefrin, ) models consumers as having both impatient “doer” preferences, representing their desire to spend now, and patient “planner” preferences, representing long‐run welfare considerations. The Behavioral Life‐Cycle hypothesis suggests that those with doer preferences may benefit from strategies that constrain their present behavior and promote saving for the future, like automating deposits into savings accounts. We analyze over 4,000 responses from the nationally representative National Financial Well‐Being Survey to (a) describe consumer characteristics associated with the decision to automate savings deposits, and (b) explore whether automation is related to improved financial welfare, especially for impatient consumers. We find that savings automation is positively associated with financial socialization (whether the respondent's family discussed financial matters growing up) and financial skill (the ability to act on financial knowledge). We also find that impatient consumers—relative to those with stronger planner preferences—have fewer liquid savings, lower financial well‐being, less confidence in their ability to raise $2,000, and more difficulty paying bills. However, as predicted, these differences between consumers with doer and planner preferences largely disappear for those who automate savings deposits. We discuss implications of this research for financial planners in helping clients improve financial welfare.

The objectives of this study were to test for differences in prescription monitoring program (PMP) use between two states, Connecticut (CT) and Rhode Island (RI), with a different PMP accessibility; to explore use of PMP reports in clinical practice; and to examine associations between PMP use and clinician's responses to suspected diversion or "doctor shopping" (i.e., multiple prescriptions from multiple providers). From March to August 2011, anonymous surveys were emailed to providers licensed to prescribe Schedule II medications in CT (N = 16,924) and RI (N = 5,567). PMP use, use of patient reports in clinical practice, responses to suspected doctor shopping, or diversion. Responses from 1,385 prescribers were received: 998 in CT and 375 in RI. PMP use was greater in CT, where an electronic PMP is available (43.9% vs 16.3%, χ(2) = 85.2, P < 0.0001). PMP patient reports were used to screen for drug abuse (36.2% CT vs 10.0% RI, χ(2) = 60.9, P < 0.0001) and detect doctor shopping (43.9% CT vs 18.5% RI, χ(2) = 68.3, P < 0.0001). Adjusting for potential confounders, responses by PMP users to suspicious medication use behavior were more likely to entail clinical response (i.e., refer to another provider odds ratio, OR, 1.75 [95% confidence interval, CI, 1.10, 2.80]; screen for drug abuse OR 1.93 [1.39, 2.68]; revisit pain/treatment agreement OR 1.97 [1.45, 2.67]; conduct urine screen OR 1.82 [1.29, 2.57]; refer to substance abuse treatment OR 1.30 [0.96, 1.75]) rather than legal intervention (OR 0.45 [0.21, 0.94]) or inaction (OR 0.09 [0.01, 0.70]). Prescribers' use of an electronic PMP may influence medical practice, especially opioid abuse detection, and is associated with clinical responses to suspected doctor shopping or diversion.

Understanding and acting on the intentions of people who are unable to communicate their wishes for future care is a complicated issue. Ian Potter provides guidance on the different powers of attorney.