Labor Economics Commons^™

Contracting With Limited Commitment: Evidence From Employment-Based Health Insurance Contracts, Keith J. Crocker, John R. Moran

Center for Policy Research

When an individual's health status is observable, but evolving over time, the key to maintaining a successful health insurance arrangement is to have the healthier members of the group cross-subsidize those who experience adverse health outcomes. We argue that impediments to worker mobility may serve to mitigate the attrition of healthy individuals from employer-sponsored insurance pools, thereby creating a de facto commitment mechanism that allows for more complete insurance of health risks than would be possible in the absence of such frictions. Using data on health insurance contracts obtained from the 1987 National Medical Expenditure Survey, we find that the …

Intergenerational Labor Market And Welfare Consequences Of Poor Health, Thomas J. Kniesner, Anthony T. Losasso

Center for Policy Research

Our research provides new econometric evidence concerning partial economic risk sharing between a frail elderly parent and an adult child. We estimate a jointly determined limited dependent variables system explaining the parent’s entry into a nursing home, the adult child’s visits to the parent, and the adult child’s labor supplied. The time allocation of adult sons is unaffected by a parent’s frail health. Adult daughters who visit a frail elderly parent daily decrease their annual labor supplied by about 1,000 hours annually, largely through labor force non-participation. The implied welfare loss to the daughter from a frail elderly parent in …

Unfinished Business: Inadequate Health Coverage For Privately Insured, Seriously Ill Children, Nancy Swigonski, Eleanor D. Kinney, Deborah A. Freund, Thomas J. Kniesner

Center for Policy Research

During the 1980s and 1990s there were great increases of health insurance coverage for poor children through the Children’s Health Insurance Program (CHIP) and extended Medicaid eligibility. Problems remain for the small number of children with serious medical conditions whose care is a high proportion of total health care expenditures on children. We report on the adequacy of health insurance coverage for a sample of children with serious and rare illnesses treated at the single tertiary care pediatric hospital in Indiana. One-third of privately insured children in our data had inadequate insurance. Compared to families with inadequate health insurance families …

Determinants Of Medical Costs Following A Diagnosis Of Depression, Regina H. Powers, Thomas J. Kniesner, Thomas W. Croghan

Center for Policy Research

Objective: Assess the determinants of medical costs for depressed individuals.

Method: Using medical insurance claims for a population of depressed individuals with employer provided insurance, we estimated multivariate models of the costs for general medical care, exclusive of costs for mental health services, following diagnosis. Explanatory variables included provider choice (psychiatrist or non-physician mental health specialist), treatment choice (medication, psychotherapy, or combination treatment); treatment adequacy as defined by APA guidelines; characteristics of depression symptoms and severity; and other demographic characteristics.

Results: On average, there were increases in the costs for general medical services in the year following diagnosis of a …

Chronic Illness And Health Insurance-Related Job Lock, Kevin T. Stroupe, Eleanor D. Kinney, Thomas J. Kniesner

Center for Policy Research

We examine job duration patterns for evidence of health insurance-related job lock among chronically ill workers or workers with a chronically ill family member. Using Cox proportional hazard models, we allow for more general insurance effects than in the existing literature to indicate the impact of health insurance and health status on workers' job durations. We use data for workers in Indiana predating the Health Insurance Portability and Accountability Act (HIPAA) to examine the potential impact of HIPAA on job mobility. Chronic illness reduced job mobility by about 40 percent among the workers in our sample who relied on their …

Relative Cohort Size: Source Of A Unifying Theory Of Global Fertility Transition, Diane J. Macunovich

Center for Policy Research

Using United Nations estimates of age structure and vital rates for nearly 200 nations at five-year intervals from 1950 through 1995, this paper demonstrates how changes in relative cohort size appear to have affected patterns of fertility across nations since 1950--not just in developed countries, but perhaps even more importantly in countries as they pass through the demographic transition. The increase in relative cohort size (defined as the proportion of the population aged 15 to 24 relative to that aged 25 to 59) which occurs as a result of declining mortality rates among children and young adults during the demographic …

Cash Constraints And Business Start-Ups: Deutschmarks Versus Dollars, Douglas Holtz-Eakin, Harvey Rosen

Center for Policy Research

In this paper we analyze microdata to explore differences in the rates at which American and German workers leave their salaried jobs to become self-employed. We document that the rate of self-employment is lower in Germany than in the U.S., and the rate of transition from wage-earning to self-employment is lower as well. We find evidence that German workers face liquidity constraints that are more severe than those of their American counterparts. Further, the difference in transition rates cannot be attributed to observable differences between German and American workers.

The Role Of Relative Cohort Size And Relative Income In The Demographic Transition, Diane J. Macunovich

Center for Policy Research

This paper summarizes the results of other analyses by the author with regard to the importance of relative cohort size (RCS) in determining male relative income (the income of young adults relative to prime-age workers) and general patterns of economic growth, and in turn influencing fertility in the currently more-developed nations. It then goes on to demonstrate that these same effects appear to have been operating in all of the 100-odd nations which have experienced the fertility transition since 1950. Parameter estimates based on the experience of all 189 countries identified by the United Nations between 1950 and 1995 are …