Health Economics Commons^™

The Effects Of Social Status On The Quality And Affordability Of Healthcare, Robert O. Burns

Honors College Theses

Access to healthcare is very important in today's society, as is the quality of said healthcare. The socioeconomic status (SES) of an individual is the most important factor when it comes to determining both the accessibility and quality of said care, and as such has been studied extensively. Across different countries, lower SES has been linked to the decreased affordability and success rates of medical treatments such as coronary heart disease medication or health risk prevention regimes. In many cases, low SES patients were found to be less likely to seek treatment than higher SES patients as the debt they …

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Health Management and Policy Presentations

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.

Reference-Dependence Effects In Benefit Assessment: Beyond The Wta-Wtp Dichotomy And Wta-Wtp Ratios, W. Kip Viscusi

Vanderbilt Law School Faculty Publications

Willingness-to-pay (WTP) values and willingness-to-accept (WTA) values have received considerable attention, but the role of reference-dependence effects is more diverse. Policies involving cost and risk may have reference point effects with respect to both cost and risk, leading to four potential valuation measures. Experimental evidence for water quality policies suggests that the cost reference effects are particularly influential in that context. There is, however, no evidence of significant reference effects for labor market estimates of the value of a statistical life. Sound application of benefit values other than WTP measures requires pertinent empirical evidence and an assessment of the underlying …

Medicaid And The Labor Supply Of Single Mothers: Implications For Health Care Reform, Vincent Pohl

Upjohn Institute Working Papers

The Patient Protection and Affordable Care Act expands Medicaid and introduces health insurance subsidies, thereby changing work incentives for single mothers. To undertake an ex ante policy evaluation of the employment effects of the PPACA, I structurally estimate a model of labor supply and health insurance choice exploiting existing variation in Medicaid policies. Simulations show that single mothers increase their labor supply at the extensive and the intensive margin by six and five percent, respectively. The PPACA leads to crowding-out of employer-sponsored health insurance of about 40 percent and increases single mothers' welfare by about $190 per month.

Price Subsidies, Diagnostic Tests, And Targeting Of Malaria Treatment: Evidence From A Randomized Controlled Trial, Jessica Cohen, Pascaline Dupas, Simone Schaner

Dartmouth Scholarship

Both under- and over-treatment of communicable diseases are public bads. But efforts to decrease one run the risk of increasing the other. Using rich experimental data on household treatment- seeking behavior in Kenya, we study the implications of this trade-off for subsidizing life-saving antimalarials sold over-the-counter at retail drug outlets. We show that a very high subsidy (such as the one under consideration by the international community) dramatically increases access, but nearly one-half of subsidized pills go to patients without malaria. We study two ways to better target subsidized drugs: reducing the subsidy level, and introducing rapid malaria tests over-the-counter. …

Mandate-Based Health Reform And The Labor Market: Evidence From The Massachusetts Reform, Jonathan T. Kolstad, Amanda E. Kowalski

Upjohn Institute Working Papers

We model the labor market impact of the key provisions of the national and Massachusetts "mandate-based" health reforms: individual mandates, employer mandates, and subsidies. We characterize the compensating differential for employer-sponsored health insurance (ESHI) and the welfare impact of reform in terms of "sufficient statistics." We compare welfare under mandate-based reform to welfare in a counterfactual world where individuals do not value ESHI. Relying on the Massachusetts reform, we find that jobs with ESHI pay $2,812 less annually, somewhat less than the cost of ESHI to employers. Accordingly, the deadweight loss of mandate-based health reform was approximately 8 percent of …

Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays

Health Management and Policy Presentations

This analysis, conducted as part of the ACA Implementation Research Network, examines economic and political forces shaping Kentucky's early experience with implementation of the Patient Protection and Affordable Care Act.

The Effect Of Medicare Eligibility On Spousal Insurance Coverage, Marcus Dillender, Karen Mulligan

Upjohn Institute Working Papers

A majority of married couples in the United States take advantage of the fact that employers often provide health insurance coverage to spouses. When the older spouses become eligible for Medicare, however, many of them can no longer provide their younger spouses with coverage. In this paper, we study how spousal eligibility for Medicare affects the health insurance and health care access of the younger spouse. We find spousal eligibility for Medicare results in the younger spouse having worse insurance coverage and reduced access to health care services.

Health Care Inflation And It's Implications For Monetary Policy, Takeshi Yagihashi, Juan Du

Economics Faculty Publications

Motivated by recent findings on the cyclical movement of both health and health spending, we construct a general equilibrium model that distinguishes health care demand from the demand for other goods. Using this model, we are able to generate inflation dynamics and cyclicality of health that match the US data. When the model is subjected to an expansionary monetary policy shock, it yields different output and inflation responses compared with a two-sector model with homogeneous demand. We show that the trade-off between leisure and health spending plays an important role in model dynamics. The model further predicts different degrees of …

Do Physicians Respond To Liability Standards?, Michael D. Frakes, Matthew Frank, Seth Seabury

Faculty Scholarship

In this paper, we explore the sensitivity in the clinical decisions of physicians to the standards of care expected of them under the law, drawing on the abandonment by states over time of rules holding physicians to standards determined by local customs and the contemporaneous adoption of national-standard rules. Using data on broad rates of surgical interventions at the county-by-year level from the Area Resource File, we find that local surgery rates converge towards national surgery rates upon the adoption of national-standard rules. Moreover, we find that these effects are more pronounced among rural counties.

Procedural Triage, Matthew B. Lawrence

Faculty Articles

Prior scholarship has assumed that the inherent value of a “day in court” is the same for all claimants, so that when procedural resources (like a jury trial or a hearing) are scarce, they should be rationed the same way for all claimants. That is incorrect. This Article shows that the inherent value of a “day in court” can be far greater for some claimants, such as first-time filers, than for others, such as corporate entities and that it can be both desirable and feasible to take this variation into account in doling out scarce procedural protections. In other words, …

Essays On Job-Related Risks And Worker Sorting, Teguh Yudo Wicaksono

Theses and Dissertations--Economics

This dissertation examines heterogeneity in the value of a statistical life (henceforth VSL) stemming from employer-provided health insurance (henceforth EHI) and worker sorting. The dissertation consists of three essays.

In the first essay (Chapter 2), I investigate the effect of health-driven productivity on the wage compensation for mortality risk, and how EHI influences VSL using the US labor market data. In this chapter I build a framework showing that the level of job risks influences the incentive of employers to provide EHI. The basic notion of the framework is that health insurance is an investment in health and health is …

Why Healthy Behavior Is The Hard Choice, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Our society is structured to encourage unhealthy diets and physically inactive lifestyles, which are key risk factors for chronic diseases including diabetes, heart diseases, and cancers. We are bombarded with advertisements for hyperprocessed foods laden with saturated fat, salt, sugar, and refined carbohydrates, “low-fat” foods often contain high amounts of sugar and salt, and parks and recreation spaces are often inaccessible or unsafe.

Four simple ideas - taxes on unhealthy products, product reformulation, improving the informational environment, and increasing healthy food accessibility - could make healthy behaviors the “default” choice for most consumers. First, taxes on unhealthy products, such as …

The Impact Of Hiv/Aids On Foreign Direct Investment: Evidence From Sub-Saharan Africa, Elizabeth Asiedu, Yi Jin, Isaac K. Kanyama

Journal of African Trade

We construct a theoretical model that examines the relationship between HIV/AIDS and foreign direct investment and employ panel data from 41 countries in Sub-Saharan Africa (SSA) to test the implications of the model. We find that HIV/AIDS has a negative but diminishing effect on FDI. Furthermore, the adverse effect occurs even when the HIV prevalence rate is as low as 0.1%. The result has important policy implications for SSA countries.

Health Care Use, Out-Of-Pocket Expenditure, And Macroeconomic Conditions During The Great Recession, Juan Du, Takeshi Yagihashi

Economics Faculty Publications

We study how macroeconomic conditions during the Great Recession affected health care utilization and out-of-pocket expenditures of American households. We use two data sources: the Consumer Expenditure (CE) Survey and the Survey of Income and Program Participation (SIPP); each has its own advantages. The CE contains quarterly frequency variables, and the SIPP provides panel data at the individual level. Consistent evidence across the two datasets shows that utilization of routine medical care was counter-cyclical, whereas hospital care was pro-cyclical during the Great Recession. When we examine the pre-recession period, the relationship between macroeconomic conditions and health care use was either …

Industry Career Guide: Health And Wellness, Paulynne Castillo, Madel Balane

Angelo King Institute for Economic and Business Studies (AKI)

The Health and Wellness Services industry belongs to the services sector. The National Statistical Coordination Board (2007) defines it as institutions that cater to the “activities of persons traveling to and staying in places outside their usual environment for not more than one consecutive year for health and wellness purposes not related to the exercise of an activity remunerated from within the place visited”. Establishments belonging to the industry, therefore, are in engaged in: 1) hospital care and treatment – refer to services offered by public and private hospitals, sanitaria and other similar services; 2) specialty clinics – pertain to …

Estimating Cost Adjustments Required To Accomplish Target Savings In Chronic Disease Management Interventions: A Simulation Study, Rafael Diaz, Joshua G. Behr, Bruce S. Britton

VMASC Publications

Chronic diseases are persistent ailments that are not preventable or curable with medication or vaccination. Many of the leading chronic conditions in industrialized societies may be related to lifestyle choices. The prevalence of these chronic conditions significantly affects the health, suffering, and longevity of patients. This paper demonstrates the utility of system dynamics as an approach to model and simulate the behavior of key cost factors in the implementation of population health management interventions. The study uses modeling and simulation as an evaluative method to identify potential savings stemming from an intervention within a well-defined population group. The model is …

Revisiting Compensating Wage Differentials: The Evidence From Employer-Provided Health Insurance, Dan Qu

Business Review

This paper uses 1996 and 2001 Survey of Income and Program Participation to examine the evidence for compensating wage differentials associated with employer-provided health insurance (EHI) in the United States. The results provide no evidence of a tradeoff between wages and EHI coverage. On the other hand, the results do suggest that employees who work in states with income taxes are more likely to receive EHI than those in states without income taxes. Fixed effects, first differencing and instrumental variable estimation are used to address the potential ability bias and endogeneity problems in wage models with EHI as an independent …

Cross Sectional Analysis Of The Demand For Prescription Pain Killers, Christopher Reed

Masters Theses

This paper is a cross-sectional analysis of the demand for prescription painkillers. Demand was broken down into illegal adult use of painkillers, illegal adolescent use, and legal prescriptions per capita for each state. Data for 2012 were taken from the National Survey on Drug Use and Health (NSDUH) and the National Prescription Audit as well as from other sources such as the Census Bureau. Prescription drug monitoring programs were found to decrease illegal use, while medical marijuana laws and poverty rates increased legal use and use among teens. Both white population and number of officers decreased illegal use among adults, …

Towards Principles And Standards For The Benefit-Cost Analysis Of Safety, W. Kip Viscusi, Scott Farrow

Vanderbilt Law School Faculty Publications

Benefit-cost analysis (BCA) is frequently applied to decisions involving public safety which requires analyzing risk and assessing options to manage risks. Principles and standards may assist analysts, decision-makers, and the public in developing and interpreting such BCAs. Principles and standards at best represent commonly held views among a community of practice. Such views are continually evolving with advances in the field. This paper presents a modularized format towards principles and standards that may assist in focusing discussion and decisions about whether such proposals actually reflect principles and standards within the benefit-cost analysis community of practice. Among topics covered are welfare …