nep-hea New Economics Papers
on Health Economics
Issue of 2005‒05‒14
five papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Optimal Paternalism: Sin Taxes and Health Subsidies By Aronsson, Thomas; Thunström, Linda
  2. Do Non-Profit Operators Provide Higher Quality of Care? Evidence from Micro-Level Data for Japan's Long-term Care Industry By Haruko Noguchi; Satoshi Shimizutani
  3. Non-Market Values and Intra-Household Gender Gap in Healthcare: The Case of Rural China By Mengtao Gao; Yang Yao
  4. The Physician-Patient Relationship Revisited - the Patient's View By Udo Schneider; Volker Ulrich
  5. A strategy for bounding attributable risk: a lung cancer example. By Minh Ha-Duong; Elizabeth Casman; Granger Morgan

  1. By: Aronsson, Thomas (Department of Economics, Umeå University); Thunström, Linda (Department of Economics, Umeå University)
    Abstract: The starting point for this paper is the potential self-control problem underlying the consumption of unhealthy food. The purpose is to analyze public policies, which are designed to correct for the welfare loss associated with such behavior. Contrary to previous studies, our analysis suggests that subsidies on wealth and health capital are part of the policy package, which can be used to implement a socially optimal resource allocation.
    Keywords: Health; Quasi-Hyperbolic Discounting; Taxes; Subsidies
    JEL: D61 D62 H21 I18
    Date: 2005–05–11
  2. By: Haruko Noguchi; Satoshi Shimizutani
    Abstract: Along with the introduction of the long-term care insurance scheme, the Japanese government in 2000 for the first time allowed for-profit operators to compete head-on with non-profit operators in the provision of at-home care services. This study examines quality differentials between the nonprofit and the for-profit sector in Japan's elderly care industry, concentrating on home helpers and staff nurses. Taking advantage of a unique and rich micro-level survey, the study finds that although nonprofit operators provide higher quality of care, as measured by simple averages of workers' characteristics, the advantage of nonprofits disappears once their higher wage is corrected for. This finding confirms that the seemingly higher quality of care provided by nonprofit operators is due to the nonprofit wage premium, resulting from their preferential status which provides non-distributional constraints and favorable tax treatment.
    Keywords: Japanese long-term care insurance, long-term care, nursing homes, home helpers, staff nurses, nonprofit wage premium, quality of care, treatment effect approach
    JEL: I11
    Date: 2005–04
  3. By: Mengtao Gao (CCER - China Center for Economic Research); Yang Yao (CCER - China Center for Economic Research)
    Abstract: This paper studies the age structure of the gender gap in household health care allocation by using survey data coillected on 1428 rural households (8414 persons) in 8 Chinese provinces. The primary concerns are rthe treatment rate and expenditure conditional on reported 2-week illnesses. To avoid the potential bias in self-reported illness, in particular, the bias arising from wome's tendency to report more illnesses than men, conditional probit and OLS analyses are adopted. in addition, to take care the possibility that some illnesses have different impacts on men and women, we suppplement the study by looking at people's responses to two specific illnesses, cold and diarrhoea, that do not have gender implications. We employ several sets of variables measuring a person's work capability, occupation, political affiliation, and education to control his potential market values. Our results show that girls under age 13 do get significantly less medical care than boys of the same age, but prime-age wives get more than the husbands, and old-age wives get less than old-age husbands. While the results for the children agree with other studies, the pattern for prime-age and old-age adults is new and consistent with the considerations proposed above.
    Keywords: China, health care allocation, gender, rural
    JEL: I31 I38
    Date: 2004–10
  4. By: Udo Schneider (University of Bayreuth); Volker Ulrich (University of Bayreuth)
    Abstract: The importance of the physician-patient relationship for the health care market is beyond controversy. Most theoretical work is done in a principal-agent framework, dealing with moral hazard problems. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient (double moral hazard). In contrast to most work looking only at the physician's perspectives, our paper concentrates on the patient's view. Estimation results using panel data support the hypotheses that physician consultation and health-relevant behavior are not stochastically independent. This means that health care demand is determined by the patient and not only by the physician. In the recursive bivariate probit model, the patient’s health-relevant behavior has a significant positive influence on the probability of a physician visit. This should be taken into account in the discussion that primary care physicians should function as gatekeepers.
    Keywords: physician-patient relationship, health behavior, bivariate probit
    JEL: I11 C33 D82
    Date: 2005–05–12
  5. By: Minh Ha-Duong (CIRED - Centre International de Recherche sur l'Environnement et le Développement - - CNRS : UMR8568 - Ecole des Hautes Etudes en Sciences Sociales;Ecole Nationale du Génie Rural des Eaux et des Forêts;Ecole Nationale des Ponts et Chaussées); Elizabeth Casman (CMU, EPP - Carnegie Mellon University, Department of Engineering and Public Policy - - Carnegie Mellon University); Granger Morgan (CMU, EPP - Carnegie Mellon University, Department of Engineering and Public Policy - - Carnegie Mellon University)
    Abstract: For diseases with more than one risk factor, the sum of probabilistic estimates of the number of cases attributable to each individual factor may exceed the total number of cases observed, especially when uncertainties about exposure and dose-response for some risk factors is high. In this study we outline a method to bound the fraction of lung cancer fatalities not attributed to specific well-studied causes. Such information serves as a "reality check" for attributional studies of the minor risk factors, and, as such, complements the traditional risk analysis. With lung cancer as our example, we attribute portions of the observed lung cancer mortality to known causes (such as smoking, residential radon, and asbestos fibers) and describe the uncertainty surrounding those estimates. The interactions among the risk factors are also quantified, to the extent possible. We then infer an upper bound on the residual risk due to "other" causes, using a coherence constraint on the total number of deaths, the maximum uncertainty principle, and the mathematics of imprecise probabilities.
    Keywords: bounding analysis, lung cancer risk, imprecise probability, epidemiology
    Date: 2004–12–23

This nep-hea issue is ©2005 by Yong Yin. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.