nep-hea New Economics Papers
on Health Economics
Issue of 2006‒07‒15
fourteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Health as a factor in regional economic development By Malmberg, Bo; Andersson, Eva
  2. Growth and Longevity from the Industrial Revolution to the Future of an Aging Society By de la Croix, David; Lindh, Thomas; Malmberg, Bo
  3. Willingness to Pay for Road Safety and Estimates of the Risk of Death: Evidence from a Swedish Contingent Valuation Study By Andersson, Henrik
  4. Counting the Deaths in Darfur: Estimating Mortality from Multiple Survey Data By Debarati Guha-Sapir; Olivier Degomme
  5. Welfare Analysis Incorporating a Structural Entry-Exit Model: A Case Study of Medicare HMOs By Shiko Murayama
  6. Factoring affecting the Demand for Health Insurance in a Micro Insurance Scheme By Bhat Ramesh; Jain Nishant
  7. Structural Change in Cigarette Demand: Cusum Tests using Panel Data By Schroeter, John R.; Fenn, Aju J
  8. The Effect of Taxes and Bans on Passive Smoking By Jérôme Adda; Francesca Cornaglia
  9. The Paradigms and Politics of Reproductive Health: UNFPA in West Java, Indonesia By Kaleen Love (QEH)
  10. Determinants of Public Health Outcomes: A Macroeconomic Perspective By Marios Zachariadis; Francesco Ricci
  11. Agent-based Investigation of Price Inflation In Health Insurance By Carl A. Johnston
  12. Medium term dynamics and inequalities under epidemics By Jean-Pierre Laffargue; Raouf Boucekkine; CORE
  13. Willingness to pay for a reduction in the mortality risk after a myocardial infarction: an aplication of the contingent valuation method to the case of eplerenone By Jose Luis Pinto-Prades; Veronica Farreras; Jaime Fernández de Bobadilla
  14. Health Information and the Choice of Fish Species: An Experiment Measuring the Impact of Risk and Benefit Information By Stephan Marette; Jutta Roosen; Sandrine Blanchemanche; Philippe Verger

  1. By: Malmberg, Bo (Institute for Futures Studies); Andersson, Eva (Institute for Housing and Urban Research (IBF))
    Abstract: Is health a forgotten factor in regional economic development? The health or ill health of the European workforce is a crucial issue as the share of old age people as well as the mean age increases. A second reason for this paper is the increased interest in the relation between health and productivity of businesses. Ill health might in this respect be a factor of severe disadvantage for regions to improve their economic performance. A third motive is policy considerations; policies directed to reduce ill health could be considered as an important tool in regional development. In order to explore health as a factor for regional economic development in Sweden we used regional as well as micro level data. The results consistently highlight health as an important determinant of regional economic performance. It is first revealed through a strong correlation in regional data between health levels and economic performance. Healthy municipalities generally have a stronger local economy than those characterised by ill health. In addition a negative effect of ill health is demonstrated in Swedish micro data. In case of sickness in our control group, both the individuals themselves, their spouses, children and colleagues are negatively affected.
    Keywords: health; regional economic development; Sweden; sickness benefit; unemployment
    JEL: I10 R11 R13
    Date: 2006–04
  2. By: de la Croix, David (Université catholique de Louvain); Lindh, Thomas (Institute for Futures Studies); Malmberg, Bo (Institute for Futures Studies)
    Abstract: Aging of the population will affect the growth path of all countries. To assess the historical and future importance of this claim we use two popular approaches and evaluate their merits and disadvantages by confronting them to Swedish data. We first simulate an endogenous growth model with human capital linking demographic changes and income growth. Rising longevity increases the incentive to get education, which in turn has ever-lasting effects on growth through a human capital externality. Secondly, we consider a reduced-form statistical model based on the demographic dividend literature. Assuming that there is a common DGP guiding growth through the demographic transition, we use an estimate from post-war global data to backcast the Swedish historical GDP growth. Comparing the two approaches, encompassing tests show that each of them contains independent information on the Swedish growth path, suggesting that there is a benefit from combining them for long-term forecasting.
    Keywords: aging population; growth path; long-term forecasting
    JEL: J11
    Date: 2006–06
  3. By: Andersson, Henrik (VTI)
    Abstract: We examine how WTP for a reduction in road-mortality risk varies with different individual characteristics and how subjective mortality-risk estimates differ from objective (statistical) mortality-risk values. Using data from a Swedish contingent valuation study, we find some support that WTP declines with age and background risk, but we find no support that WTP varies with health status. Further, we find that respondents underassess their own mortality risks, both road- and total-mortality risks, compared to the objective risk measures for Sweden at the time of the survey.
    Keywords: age; background risk; contingent valuation; health status; willingness to pay; risk perception; road safety
    JEL: C51 D61 J28
    Date: 2006–07–04
  4. By: Debarati Guha-Sapir (WHO Collaborating Centre for Research on Disaster Epidemiology (CRED), School of Public Health, Université Catholique de Louvain); Olivier Degomme (WHO Collaborating Centre for Research on Disaster Epidemiology (CRED), School of Public Health, Université Catholique de Louvain)
    Date: 2006–04
  5. By: Shiko Murayama
    Abstract: Should the government subsidize entry to promote competition? In theory, free entry does not guarantee the socially optimum number of entrants. In differentiated product markets, free entry can result either in excessive or insufficient entry. In this paper I propose an empirical framework to address this issue with a case study of the Medicare HMO market for 2003 and 2004. I perform counterfactual welfare simulations with different entry conditions and with different government payment rates to HMOs. The results indicate that uniformly raising the payment rate lowers national welfare, which supports the government's efforts to contain the payment rate in my sample years. A comparison of the cases with and without entry and/or market power indicates that this welfare loss does not come from additional entry, but instead the oligopolistic market structure and market distortion from the payment rate subsidy. The number of entrants is likely to be insufficient.
    Date: 2006–06
  6. By: Bhat Ramesh; Jain Nishant
    Abstract: Health insurance schemes are increasingly recognised as preferable mechanisms to finance health care provision. In this direction micro health insurance schemes and community based health insurance schemes are assuming significant importance in reaching large number of people. However, at the community level despite low premiums the penetration of health insurance is small. The objective of this paper is to analyse factors determining the demand for private health insurance in a micro insurance scheme setting. The study uses two-stage model to examine this issue. First, we determine the factors which affect the insurance purchase decisions and at second level we focus on studying factors which affect the amount of insurance purchase using Heckman two-stage estimation procedure. The data of this study is based on survey and collection of primary data from the Anand district of Gujarat where Charotar Arogya Mandal is offering a health insurance scheme. The results indicate that income and healthcare expenditure are significant determinants of health insurance purchase. Age, coverage of illnesses and knowledge about insurance were also found to be affecting health insurance purchase decision positively. For the decision regarding amount of health insurance purchase, income was found to be having significant but non-linear relationship. In addition, number of children in the family, age, and perception regarding future healthcare expenditure were also found to be significant. The study discusses implications of these results.
    Date: 2006–07–05
  7. By: Schroeter, John R.; Fenn, Aju J
    Abstract: We conduct cusum tests of structural change in a rational addiction model of cigarette demand estimated using a panel of annual time series of state-level data. In contrast to the one previous application of cusum tests to the question of cigarette demand stability, our results provide strong evidence of downward shifts in demand during the modern era of health warnings and anti-smoking campaigns.
    Keywords: cigarette demand, rational addiction, cusum tests
    JEL: D1
    Date: 2005–09–30
  8. By: Jérôme Adda (University College London and Institute for Fiscal Studies); Francesca Cornaglia (University College London, CEP and IZA Bonn)
    Abstract: This paper evaluates the effect of excise taxes and bans on smoking in public places on the exposure to tobacco smoke of non-smokers. We use a novel way of quantifying passive smoking: we use data on cotinine concentration – a metabolite of nicotine – measured in a large population of non-smokers over time. Exploiting state and time variation across US states, we show that excise taxes have a significant effect on passive smoking but smoking bans have contrasting effects on non-smokers. While bans in public transportation or in schools decrease the exposure of non smokers, bans in recreational public places perversely increase their exposure by displacing smokers to private places where they contaminate non smokers, and in particular young children. Bans affect socio-economic groups differently: we find that smoking bans increase the exposure of poorer individuals, while it decreases the exposure of richer individuals.
    Keywords: passive smoking, bans, taxes
    JEL: I1
    Date: 2006–07
  9. By: Kaleen Love (QEH)
    Abstract: The central aim of this research has been to examine a particular development intervention by exposing its underlying paradigms and the discourses this generated. It was hypothesized that there is often a disjuncture between the changes explicitly pursued by such an intervention and those that result, which can then be linked to the paradoxical relationship between these paradigms and discourses. In other words, the incongruence of development aims and project actualities arises from the tensions between competing agendas and understandings. Therefore by exposing the contradictions in these underlying paradigms we gain insight into the politics of change. The programme studied was the UN Population Fund project in West Java, Indonesia, examining its layers through multi-sited research based in the centre (Jakarta), provincial government (Bandung) and two villages in the province. A Foucauldian framework, emphasizing local politics as a site of both physical and semiotic struggle and integrated within the analytical framework of a hermeneutical circle, was employed. In studying these gender-targeted programmes, conclusions were drawn on the nature of institutional discourse creation, bureaucratic ignorance, power in its many facets, and the construction and contestation of gender roles.
  10. By: Marios Zachariadis (Department of Economics, ,University of Cyprus); Francesco Ricci (Department of Economics University of Cyprus; THEMA)
    Keywords: Education, life expectancy, external effects.
    JEL: O30 O40
    Date: 2006–07–04
  11. By: Carl A. Johnston (Interdisciplinary Center for Economic Science, George Mason University)
    Date: 2006–07–04
  12. By: Jean-Pierre Laffargue (PSE); Raouf Boucekkine; CORE
    Keywords: Epidemic, hysteresis, echo effect, overlapping generation model
    JEL: I12 O40
    Date: 2006–07–04
  13. By: Jose Luis Pinto-Prades (Department of Economics, Universidad Pablo de Olavide); Veronica Farreras (Department of Applied Economics. Universidad Autónoma de Barcelona); Jaime Fernández de Bobadilla (Pfizer)
    Abstract: Background: In order to allocate health care resources more efficiently it is necessary to relate health improvements provided by new medicines with their cost. It is necessary to ascertain when the additional cost of introducing a new health technology is justified by the additional health gain produced. Eplerenone is a new medicine that reduces the risk of death after myocardial infarction (MI) but produces additional cost to the health system. The contingent valuation approach can be used to measure the monetary value of this risk reduction. Objective: to estimate society’s willingness to pay (WTP) for a new medicine that reduces by 2% the risk of death after MI. Methods: We used a contingent valuation approach to evaluate WTP amongst members of the general population. We used the ex-ante and the ex-post approach. In the ex-ante approach subjects are asked if they would accept an increase in their taxes in order to have access to Eplerenone should they need it in the future. In the ex-post approach subjects are asked if they would pay a certain amount of money as co-payment per month during five years if they suffered a MI. We used the Dichotomous Choice method, using five bids in each approach. The WTP was estimated using both single-bound and double-bound dichotomous choice (SBDC, DBDC). Extensive piloting (n=187) preceded the final survey (n=350). Results: The WTP in the ex-ante case was €58 per year under both SBDC and DBDC. In the ex-post case monthly WTP was €144 for the SBDC and €85 for the DBDC. Subjects with higher income and subjects with a higher perception of risk showed a higher WTP (p<0.05). Conclusions: Society is willing to pay an additional amount of money in order to give Eplerenone to present and future patients. We estimate that €85 per month is a conservative estimate of the monetary value of a 2% risk reduction in mortality after MI and to spend this additional amount of money in Eplerenone can be considered an efficient policy.
    Keywords: contingent valuation, myocardial infarction, mortality, cost-benefit.
    JEL: I10
    Date: 2006–07
  14. By: Stephan Marette (Center for Agricultural and Rural Development (CARD); Food and Agricultural Policy Research Institute (FAPRI)); Jutta Roosen; Sandrine Blanchemanche; Philippe Verger
    Abstract: An experiment was conducted in France to evaluate the impact of health information on consumers' choice between two different types of fish. Successive messages revealing risks (methylmercury) and benefits (omega-3s) of consuming the fish, along with consumption recommendations, were delivered. Results show a significant difference of reaction according to the order and type of information. The information about risks had a larger marginal impact on change in willingness to pay (WTP) than did the information about benefits. While the results show that detailed messages on risks/benefits, including recommendations for nutrition behavior, matter in the modification of WTP, 40% of respondents did not change their initial choices after the revelation of health information.
    Keywords: experimental economics, fish consumption, health information, nutrition.
    JEL: C9 D8 I1
    Date: 2006–04

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