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on Health Economics |
| By: | Pedro Pita Barros; Matilde P. Machado; Anna Sanz de Galdeano |
| Abstract: | In this paper we estimate the impact of health insurance coverage beyond National Health Insurance on the demand for several health services. Traditionally, the literature has tried to deal with the endogeneity of the private (extra) insurance decision by finding instrumental variables. It is hard to think, however, of any variable that a priori would be a good instrument and, therefore, we take a different approach. We concentrate on the most common health insurance plan in the Portuguese Health Survey, (ADSE), which is given to all civil servants and their dependants. We argue that this insurance is exogenous for most people i.e. not correlated with their health status. Under this identifying assumption we estimate the impact of having ADSE coverage on three different health services using a matching estimator technique. The measures of demand for health services are number of visits, number of blood and urine tests, and the probability of visiting a dentist. Preliminary results show large effects of ADSE for number of visits and tests among the young (18 to 30 years old) but only for tests are these effects statistically significantly different from zero. The magnitude of the effects represent 21.8 and 30 percent of the average number of visits and tests for the young. On the contrary we find no evidence of moral hazard on the probability of visiting a dentist. Finally, we argue that there is evidence of a positive cumulative effect of ADSE over the years. |
| Date: | 2005–10 |
| URL: | http://d.repec.org/n?u=RePEc:cte:werepe:we055928&r=hea |
| By: | Denis Drechsler; Johannes Jütting |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwwpp:dp517&r=hea |
| By: | Jorgen Mortensen (CEPS, Centre for European Policy Studies); C. Katharina Spiess (DIW Berlin); Torsten Schneider (DIW Berlin); Joan Costa-Font (London School of Economics and CAEPS (University of Barcelona)); Concepcio Patxot (CAEPS (University of Barcelona)) |
| Abstract: | This paper presents a discussion of some general conceptual and empirical issues of increasing importance for the analysis of the consequences of ageing: the potential trade-off between ensuring informal health care for the elderly and at the same time achieving an increase in the employment participation ratio for women. It first provides an overview of some general issues in health economics and then turns to some theoretical and empirical investigations of these issues. The future of health care for the elderly is, as demonstrated above, a most important aspect of the prospects for health care in general. The policy issues, however, do not present themselves in the same manner for all member states. In fact, the forward path of old-age care will be greatly determined by the starting position with respect to the level of formal and informal care, the present state of affairs as far as female labour market participation is concerned and the existing patterns of financing of old-age care. |
| Date: | 2004–04 |
| URL: | http://d.repec.org/n?u=RePEc:epr:enepop:06&r=hea |
| By: | P R Agénor |
| Abstract: | This paper studies the optimal allocation of government spending between infrastructure and health (which affects labor productivity as well as household utility) in an endogenous growth framework. A key feature of the model is that infrastructure affects not only the production of goods but also the supply of health services. The first part considers the case where health enters as a flow in production and utility, whereas the second focuses on a "stock" approach. Growth- and utility-maximizing rules for output taxation and the allocation of public spending are derived. It is shown, in particular, that the welfare-maximizing share of spending on health exceeds the growth-maximizing share. |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:man:cgbcrp:62&r=hea |
| By: | J. ALBRECHT; M. NEYT; T. VERBEKE |
| Abstract: | The public choice literature suggests that bureaucrats might join forces with specific pressure and industrial groups which advocate an expansion of health care activities. As a result, the ongoing process of bureaucratisation can be a driving force behind the overproduction of health care services. In addition, Michel Foucault was the first to depict medicalisation and normalisation as processes part of a broader institutional infrastructure set up to control individuals. Both processes require a strong bureaucracy, established by the ruling elites. For our empirical analysis, the share of government employment in total employment has been used as a proxy for bureaucracy. Our results show that the process of bureaucratisation has a very significant and positive influence on national health care expenditures per capita in 20 European countries. Together with the evolution of per capita income, we can conclude that the ongoing bureaucratisation is one of the driving forces behind the rise of health care expenditures in Europe. A similar conclusion holds for the research intensity of the country. However, the combination of a high level of bureaucratisation and a high research intensity results in lowering per capita health expenditures. Our results furthermore confirm that the ageing of the population is consistently not significant once bureaucratisation is included in the analysis. |
| Date: | 2005–10 |
| URL: | http://d.repec.org/n?u=RePEc:rug:rugwps:05/335&r=hea |
| By: | N. GEEROMS; P. VAN KENHOVE; W. VERBEKE |
| Abstract: | Given the importance of meaningful audience segmentation in creating effective health advertisements, this study proposes a new segmentation approach based on a theoretical structure of eight fundamental consumer needs. The authors demonstrate the usefulness of this new method in the process of developing appropriate health advertisements in the context of fruit and vegetable consumption. Results of a two-step cluster analysis reveal five different health segments to exist with different health-realted need patterns. Significant differences exist between these segments both with regard to (category-specific) fruit and vegetable consumption and reactions toward fruit and vegetable health advertisements. In general, a segment’s reactions toward appropriate need-related health advertising were significantly more positive than its reactions toward health advertising that has a general character (i.e. not responsive to a segment’s underlying needs). Based on these results some practical suggestions and recommendations are offered for health communicators to use when developing need-related health advertisements to audiences with specific health-related need patterns. |
| Date: | 2005–10 |
| URL: | http://d.repec.org/n?u=RePEc:rug:rugwps:05/336&r=hea |
| By: | Robert S. Goldfarb (The George Washington University); Thomas C. Leonard (Princeton University); Steven M. Suranovic (The George Washington University) |
| JEL: | I |
| Date: | 2005–11–08 |
| URL: | http://d.repec.org/n?u=RePEc:wpa:wuwphe:0511001&r=hea |
| By: | Steven M. Suranovic (The George Washington University); Robert S. Goldfarb (The George Washington University) |
| Abstract: | This paper presents a behavioral economics model with bounded rationality to describe an individual¡¯s food consumption choices that lead to weight gain and dieting. Using a physiological relationship determining calories needed to maintain weight, we simulate the food consumption choices of a representative female over a 30 year period. Results show that a diet will reduce weight only temporarily. Recurrence of weight gain leads to cyclical dieting, which reduces the trend rate of weight increase. Dieting frequency is shown to depend on decision period length, dieting costs, and habit persistence. |
| Keywords: | Dieting, Behavioral economics, Weight cycles, |
| JEL: | I |
| Date: | 2005–11–08 |
| URL: | http://d.repec.org/n?u=RePEc:wpa:wuwphe:0511002&r=hea |
| By: | Steven M. Suranovic (The George Washington University) |
| Abstract: | This paper presents a model of smoking choice in which rationality is bounded by limitations in intertemporal computational abilities. The model is applied to the youth decision to initiate smoking. Lifetime smoking paths of representative smokers indicate that youths may experience a reduction in lifetime utility and come to regret their decision to smoke. It is suggested that public policy interventions that raise the near term cost of smoking will be more effective in reducing lifetime smoking than informational campaigns that emphasize future health costs. However, youth taxes would have to be quite high to substantially reduce smoking rates among youths who have already begun to smoke. Also, low youth taxes would not prevent future smoking as an adult, although they would reduce smoking rates and lead to earlier quitting. |
| Keywords: | Cigarettes, smoking, addiction, Behavioral economics |
| JEL: | I12 D11 D60 D91 |
| Date: | 2005–11–08 |
| URL: | http://d.repec.org/n?u=RePEc:wpa:wuwphe:0511003&r=hea |
| By: | Jean-Christophe Caffet (EUREQua) |
| Abstract: | Most studies on the green tax reform issue point out that environmental taxes exacerbate pre-existing tax distortions, thereby increasing the welfare costs associated with the overall tax code. As a result, the optimal environmental tax should lie below the Pigovian level (or marginal social damages). This article challenges this finding by arguing that health benefits from reduced pollution may sufficiently affect labor supply to create benefit-side tax interactions which, in turn, may be of the same magnitude as cost-side ones. Using a simple general equilibrium model that assumes the existence of a social security system, this paper shows that the optimal environmental tax rate could be greater than traditionally thought. |
| Keywords: | Environmental tax, double dividend, employment, health, social security. |
| JEL: | D60 H21 H23 I18 J22 Q28 |
| Date: | 2005–07 |
| URL: | http://d.repec.org/n?u=RePEc:mse:wpsorb:v05049&r=hea |
| By: | Lucien Gardiol; Pierre-Yves Geoffard; Chantal Grandchamp |
| Abstract: | This paper provides an analysis of the health insurance and health care consumption. A structural microeconomic model of joint demand for health insurance and health care is developed and estimated using full maximum likelihood method using Swiss insurance claims data for over 60 000 adult individuals. The estimation strategy relies on the institutional features of the Swiss system, in which each individual chooses among the same menu of contracts, ranked by the size of their deductible. The empirical analysis shows strong and robust evidence of selection effects. Nevertheless, once selection effects are controlled for, an important incentive effect ("ex-post moral hazard") remains. A decrease in the copayment rate from 100% to 10% increases the marginal demand for health care by about 90% and from 100% to 0% by about 150%. The correlation between insurance coverage and health care expenditures may be decomposed into the two effects: 75% may be attributed to selection, and 25 % to incentive effects. |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:pse:psecon:2005-38&r=hea |
| By: | Charles Link (Department of Economics,University of Delaware) |
| Abstract: | Case, Lubotsky, and Paxson (2002), using cross-sectional data, found a positive relationship between health and income and that the income relationship becomes more protective of children from higher income families as children age. Currie and Stabile (2003) point out that panel data allow the researcher to differentiate between the mechanisms underlying this relationship. Using a panel of Canadian children, they find that low-SES children respond to health shocks in the same way as high-SES children but that low-SES children, compared to high-SES children, are subject to more shocks as they age. To our knowledge we are unaware of any studies of the gradient that use panels of U.S. children. Our study utilizes the Medical Expenditures Panel Survey and the Child Development Supplements of the PSID. Our results for U.S. children are contrary to those found for children in Canada. |
| JEL: | I1 |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:dlw:wpaper:05-18&r=hea |