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David Powell

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Full-Text Articles in Health Economics

Do Medical Marijuana Laws Reduce Addictions And Deaths Related To Pain Killers?, David Powell, Rosalie Pacula, Mireille Jacobson Feb 2018

Do Medical Marijuana Laws Reduce Addictions And Deaths Related To Pain Killers?, David Powell, Rosalie Pacula, Mireille Jacobson

David Powell

Recent work finds that medical marijuana laws reduce the daily doses filled for opioid analgesics among Medicare Part-D and Medicaid enrollees, as well as population-wide opioid overdose deaths. We replicate the result for opioid overdose deaths and explore the potential mechanism. The key feature of a medical marijuana law that facilitates a reduction in overdose death rates is a relatively liberal allowance for dispensaries.  As states have become more stringent in their regulation of dispensaries, the protective value generally has fallen. These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids. 

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Imperfect Synthetic Controls: Did The Massachusetts Health Care Reform Save Lives?, David Powell Dec 2017

Imperfect Synthetic Controls: Did The Massachusetts Health Care Reform Save Lives?, David Powell

David Powell

In 2006, Massachusetts enacted comprehensive health care reform which served as a model for the Affordable Care Act. I study the mortality effects of the reform using synthetic control estimation, relaxing two critical assumptions required to implement this method.  The traditional approach assumes the existence of a perfect synthetic control, which cannot exist if the outcomes of the treated unit are outside of the "convex hull" or functions of transitory shocks.  I propose simple modifications to relax these restrictions.  The new estimator outperforms the traditional method in simulations.   I estimate that the Massachusetts Health Care Reform reduced mortality by 3%.

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Supply-Side Drug Policy In The Presence Of Substitutes: Evidence From The Introduction Of Abuse-Deterrent Opioids, Abby Alpert, David Powell, Rosalie Liccardo Pacula Dec 2016

Supply-Side Drug Policy In The Presence Of Substitutes: Evidence From The Introduction Of Abuse-Deterrent Opioids, Abby Alpert, David Powell, Rosalie Liccardo Pacula

David Powell

Overdose deaths from prescription opioid pain relievers nearly quadrupled between 1999 and 2010.  We study the consequences of one of the largest supply disruptions to date to abusable opioids – the introduction of an abuse-deterrent version of OxyContin in 2010.  Supply-side interventions which limit access to opioids may have the unintended consequence of increasing use of substitute drugs, including heroin.  Exploiting cross-state variation in OxyContin exposure, we find that states with the highest initial rates of OxyContin misuse experienced the largest increases in heroin deaths.  Our results imply that the recent heroin epidemic is largely due to the reformulation of …

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Disentangling Moral Hazard And Adverse Selection In Private Health Insurance, David Powell, Dana Goldman Dec 2015

Disentangling Moral Hazard And Adverse Selection In Private Health Insurance, David Powell, Dana Goldman

David Powell

Moral hazard and adverse selection create inefficiencies in private health insurance markets and understanding the relative importance of each factor is critical for policy.   We use claims data from a large firm which changed health insurance plan options to isolate moral hazard from plan selection.  Using an instrumental variables quantile regression approach, we estimate the differential causal impact of each health insurance plan on the entire distribution of medical expenditures.  We account for systematic sample attrition during the sample period by conditioning on a nonseparable sample selection adjustment.   Our estimates imply that 54% of the additional medical spending …

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Medical Care Spending And Labor Market Outcomes: Evidence From Workers' Compensation Reforms, David Powell, Seth Seabury Jan 2015

Medical Care Spending And Labor Market Outcomes: Evidence From Workers' Compensation Reforms, David Powell, Seth Seabury

David Powell

This paper studies the effectiveness of medical care spending on improving labor outcomes. Injuries sustained at work represent large income and welfare losses to households and there is a significant policy interest in reducing these burdens. Workers' compensation program is a large government program which provides monetary and medical benefits to injured workers. Despite the potential importance of medical care in improving the health and labor productivity of injured workers, little research has addressed the relationship between medical care provided through workers' compensation and post-injury labor outcomes. This paper exploits the 2003-2004 California workers' compensation reforms which reduced medical care …

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