Immediate gratification and continued medical insurance preparedness: the roles of future orientation and relative deprivation
6 affiliations
- 1School of Humanities and Management, Youjiang Medical University for Nationalities
- 2School of Finance, City University of Macau
- 3Graduate School of Medical Sciences, Kanazawa University
- 4School of Medical and Nursing, Shandong Vocational University of Foreign Affairs
- 5School of Languages and Cultures, Youjiang Medical University for Nationalities
- 6Division of Electrical, Information and Communication Engineering, Kanazawa University
Abstract
Background: Sustained participation in medical insurance is essential for the effectiveness and stability of social protection systems. Despite high coverage rates, many individuals show unstable enrollment patterns, characterized by repeated interruptions and re-entry. Existing research has mainly focused on institutional and economic explanations, while the psychological mechanisms underlying continued insurance preparedness remain underexplored. Drawing on socioemotional selectivity theory, this study examines how immediate gratification relates to continued insurance preparedness through future orientation, with relative deprivation as a key boundary condition.
Methods: A dual-study research design was adopted. Study 1 employed a scenario-based experiment with a 2 × 2 between-subjects design to vary immediate-gratification and relative-deprivation framing and examine differences in future-orientation responses across conditions using two-way analysis of covariance (ANCOVA), controlling for gender, age, living allowance, and hukou. Study 2 utilized survey data collected from urban and rural residents in Guangxi, China, and applied PLS-SEM to test a moderated mediation model linking immediate gratification, future orientation, relative deprivation, and continued insurance preparedness.
Results: Study 1 showed that high immediate-gratification framing was associated with lower future orientation than low immediate-gratification framing, with this difference becoming larger under high relative deprivation. Study 2 further showed that immediate gratification was negatively associated with future orientation, which in turn was positively associated with self-reported continued insurance preparedness. Although the direct association between immediate gratification and preparedness was not significant, the indirect association through future orientation was significant and became stronger as relative deprivation increased. Multigroup analysis further suggested a stronger indirect association among rural-hukou respondents than among urban-hukou respondents, although the between-group difference did not remain statistically significant after adjustment for multiple comparisons.
Conclusion: Continued insurance preparedness was closely associated with future-oriented cognition, while immediate gratification was indirectly associated with lower preparedness through lower future orientation, particularly under higher relative deprivation. These findings advance understanding of the psychological correlates of self-reported readiness to maintain medical insurance participation and provide practical insights for supporting future-oriented enrollment planning.
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BibTeX
@article{shi2026immediate,
title = {{Immediate gratification and continued medical insurance preparedness: the roles of future orientation and relative deprivation}},
author = {Long Shi and Qizhe Zhao and Hongcheng Liu and Wenxu Li and Panzhen Zhao and Caisheng Liao},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1987239},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1987239/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Immediate gratification and continued medical insurance preparedness: the roles of future orientation and relative deprivation
AU - Long Shi
AU - Qizhe Zhao
AU - Hongcheng Liu
AU - Wenxu Li
AU - Panzhen Zhao
AU - Caisheng Liao
PY - 2026
DA - 2026/10/19
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1987239
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1987239/full
AB - Background: Sustained participation in medical insurance is essential for the effectiveness and stability of social protection systems. Despite high coverage rates, many individuals show unstable enrollment patterns, characterized by repeated interruptions and re-entry. Existing research has mainly focused on institutional and economic explanations, while the psychological mechanisms underlying continued insurance preparedness remain underexplored. Drawing on socioemotional selectivity theory, this study examines how immediate gratification relates to continued insurance preparedness through future orientation, with relative deprivation as a key boundary condition. Methods: A dual-study research design was adopted. Study 1 employed a scenario-based experiment with a 2 × 2 between-subjects design to vary immediate-gratification and relative-deprivation framing and examine differences in future-orientation responses across conditions using two-way analysis of covariance (ANCOVA), controlling for gender, age, living allowance, and hukou. Study 2 utilized survey data collected from urban and rural residents in Guangxi, China, and applied PLS-SEM to test a moderated mediation model linking immediate gratification, future orientation, relative deprivation, and continued insurance preparedness. Results: Study 1 showed that high immediate-gratification framing was associated with lower future orientation than low immediate-gratification framing, with this difference becoming larger under high relative deprivation. Study 2 further showed that immediate gratification was negatively associated with future orientation, which in turn was positively associated with self-reported continued insurance preparedness. Although the direct association between immediate gratification and preparedness was not significant, the indirect association through future orientation was significant and became stronger as relative deprivation increased. Multigroup analysis further suggested a stronger indirect association among rural-hukou respondents than among urban-hukou respondents, although the between-group difference did not remain statistically significant after adjustment for multiple comparisons. Conclusion: Continued insurance preparedness was closely associated with future-oriented cognition, while immediate gratification was indirectly associated with lower preparedness through lower future orientation, particularly under higher relative deprivation. These findings advance understanding of the psychological correlates of self-reported readiness to maintain medical insurance participation and provide practical insights for supporting future-oriented enrollment planning.
SN - 2296-2565
ER -