Organisational management culture and employers' health insurance offering strategies in the USA: an Ubuntu-based random utility modelling approach

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This article takes an approach to explaining the behavioural manifestations of the decision making in US companies' offer of health insurance that is grounded not only on their cost minimising behaviour, but also in a humanness dimension based on the African concept of Ubuntu, and the Random Utility framework. The choice process is modelled as a tripartite decision making, using a nationally representative random sample of 1,061 US companies from the Dunn and Bradstreet Business data. The results show that the relationship between management culture and health plan offering strategy is dependent on other relevant covariates, which when left out, leads to the problem of omitted variables bias. However, when all variables are included exogenously in this relationship, it results in management culture not affecting significantly companies' scope of plan offering. When the exogeneity assumption is relaxed through recursively Bivariate Probit modelling, a highly significant management culture effect is observed, as companies with groups and formal committee management culture are seen to be 1.58 times less likely to choose a multiple plan strategy over a single plan strategy.