nep-hea New Economics Papers
on Health Economics
Issue of 2013‒01‒07
34 papers chosen by
Yong Yin
SUNY at Buffalo

  1. Longevity, pollution and growth By Natacha Raffin; Thomas Seegmuller
  2. The impact of government expenditure on prepayment for health services: Evidence from cointegration analysis in heterogeneous panel data By Vanneste J.; Zhang Y.
  3. Health Consequences of Easier Access to Alcohol: New Zealand Evidence By Scrimgeour, Dean; Conover, Emily
  4. Breastfeeding and child cognitive outcomes: Evidence from a hospital-based breastfeeding support policy By Del Bono, Emilia; Rabe, Birgitta
  5. Predicting health behaviors with economic preferences and perceived control By Lynn Conell-Price; Julian Jamison
  6. Medicaid insurance in old age By Mariacristina De Nardi; Eric French; John Bailey Jones
  7. Fetal origins and parental responses By Douglas Almond; Bhashkar Mazumder
  8. Workplace size and sickness absence transitions By Lindgren, Karl-Oskar
  9. War, Health, and Educational Attainment: A Panel of Children during Burundi’s Civil War By Tom Bundervoet
  10. Armed Conflict, Household Victimization, and Child Health in Côte d'Ivoire By Camelia Minoiu; Olga N. Shemyakina
  11. Mental Health and Labour Supply: Evidence from Mexico’s Ongoing Violent Conflicts By Maren M. Michaelsen
  12. Trade Union Membership and Sickness Absence: Evidence from a Sick Pay Reform By Laszlo Goerke; Markus Pannenberg
  13. Benefit Morale and Cross-Country Diversity in Sick Pay Entitlements By Daniel Arnold
  14. More on the optimal demand for long-term care insurance By Albane Tarnaud; Hervé Leleu; David Crainich
  15. The cyclicality of education, health, and social security government spending By António Afonso; João Tovar Jalles
  16. Financing Health Care Expenditure in the OECD Countries: Evidence from a Heterogeneous, Cross-Sectionally Dependent Panel By Felipa de Mello-Sampayo; Sofia de Sousa Vale
  17. Public Health Insurance Expansions and Hospital Technology Adoption By Seth Freedman; Haizhen Lin; Kosali Simon
  18. Evaluating the Effect of Ownership Status on Hospital Quality: The Key Role of Innovative Procedures By Gobillon, Laurent; Milcent, Carine
  19. The Effects of Disability Insurance: Evidence From Social Security's Disabled-Widow Program By Perry Singleton
  20. Cost Sharing and Hospitalizations for Ambulatory Care Sensitive Conditions By Alejandro Arrieta; Ariadna García-Prado Author-Email:
  21. Enrolling the Self-Employed in Mandatory Health Insurance in Colombia: are we missing other factors? By Alejandro Arrieta; Ariadna García Prado; Giota Panopoulou
  22. The Effects of Information, Social and Economic Incentives on Voluntary Undirected Blood Donations: Evidence from a Randomized Controlled Trial in Argentina By Victor Iajya; Nicola Lacetera; Mario Macis; Robert Slonim
  23. Increasing Our Understanding of the Health-Income Gradient in Children By Jason Fletcher; Barbara L. Wolfe
  24. Fast-Food Restaurant Advertising on Television and Its Influence on Youth Body Composition By Michael Grossman; Erdal Tekin; Roy Wada
  25. The RAND Health Insurance Experiment, Three Decades Later By Aviva Aron-Dine; Liran Einav; Amy Finkelstein
  26. The Nexus of Social Security Benefits, Health, and Wealth at Death By James M. Poterba; Steven F. Venti; David A. Wise
  27. Losing Heart? The Effect of Job Displacement on Health By Sandra E. Black; Paul J. Devereux; Kjell G. Salvanes
  28. The causal in fluence of social capital on immigrant health conditions in Canada. By Laporte, Audrey; Berchet, Caroline
  29. Care & cure combined: Using simulation to develop organization design theory for health care processes. By Pieters, A.; Oorschot, K.E. van; Akkermans, H.A.
  30. Public Expenditure Benefit Incidence on Health: Selective Evidence from India. By Chakraborty, Lekha; Singh, Yadawendra; Jacob, Jannet Farida
  31. Assessing Impact of Health Oriented Aid on Infant Mortality Rates By Yousuf, Ahmed Sadek
  32. Corruption and health expenditure in Italy By Lagravinese, Raffaele; Paradiso, Massimo
  33. Obesity epidemic: the role of retailing sector in promoting fruit and vegetable consumption By Fioriti, Linda; Marchini, Andrea; Diotallevi, Francesco; Pampanini, Rossella
  34. Drivers of health care expenditure: Does Baumol's cost disease loom large? By Colombier, Carsten

  1. By: Natacha Raffin (University Paris Ouest Nanterre la Défense, EconomiX and Climate Economics Chair.); Thomas Seegmuller (Aix-Marseille University (Aix-Marseille School of Economics), CNRS and EHESS.)
    Abstract: We analyze the interplay between longevity, pollution and growth. We develop an OLG model where longevity, pollution and growth are endogenous. The authorities may provide two types of public services, public health and environmental maintenance, that participate to increase agents’ life expectancy and to sustain growth in the long term. We show that global dynamics might be featured by a high growth rate equilibrium, associated with longer life expectancy and a environmental poverty trap. We examine changes in public policies: increasing public intervention on health or environmental maintenance display opposite effects on global dynamics, i.e. on the size of the trap and on the level of the stable balanced growth path. On the contrary, each type of public policy induces a negative leverage on the long run rate of growth.
    Keywords: Life expectancy; Pollution; Health; Growth.
    JEL: I15 O44 Q56
    Date: 2012–10–30
  2. By: Vanneste J.; Zhang Y.
    Abstract: Prepayment of health care ?financing is a crucial factor to ensure that all individuals have access to effective public and personal health care at a¤ordable prices. However, it is important to fi?nd out what the determinants of the level of prepayment are. More speci?cally, does more government expenditure mean higher prepayment rates in the health ?financing system? What are the different effects of government expenditure towards the two fi?nancing sectors, public ?financing and private prepaid plans, respectively? To answer these questions, the present paper introduces a three-sector health ?nance model and uses 34 OECD member data over the 1990-2009 period through panel cointegration analysis. Our fi?ndings show that, overall, government expenditure increases the level of prepayment in the health ?financing system, although the improvement is varied across economies. Our research also highlights that government expenditure has a signi?cant positive effect on public ?nancing in cases where the system is further divided by ?financing sectors. However, it does not discourage the growth of private prepaid plans.
    Date: 2012–12
  3. By: Scrimgeour, Dean (Department of Economics, Colgate University); Conover, Emily (Department of Economics, Colgate University)
    Abstract: We evaluate the health effects of a reduction in New Zealand's minimum legal purchase age for alcohol. Difference-in-differences (DD) estimates show a substantial increase in alcohol-related hospitalizations among those newly eligible to purchase liquor, around 24.6% (s.e.=5.5%) for males and 22% (s.e.=8.1%) for females. There is less evidence of an effect among ineligible younger cohorts. There is little evidence of alcohol either complementing or substituting for drugs. We do not find evidence that earlier access to alcohol is associated with learning from experience. We also present regression discontinuity estimates, but emphasize DD estimates since in a simulation of a rational addiction model DD estimates are closer than regression discontinuity estimates to the policy's true effect.
    Keywords: alcohol, minimum purchase age, youth, health, hospitalizations, New Zealand
    JEL: I12 I18 J13
    Date: 2012–01
  4. By: Del Bono, Emilia; Rabe, Birgitta
    Abstract: This paper estimates the causal effects of breastfeeding on early child development using exogenous variation in breastfeeding support policies across UK maternity hospitals. Based on data from the Millennium Cohort Study, we find that mothers giving birth in hospitals where such policies are implemented are between 8 and 9 percentage points more likely to breastfeed exclusively at 4 and 8 weeks than mothers who give birth in other hospitals. The effect of breastfeeding are found to be large and positive on many different measures of child cognitive development throughout early childhood. In contrast to the previous literature, we find no statistically significant impact of breastfeeding on a number of health outcomes, but we see an improvement in child emotional development and maternal mental health.
    Date: 2012–12–14
  5. By: Lynn Conell-Price; Julian Jamison
    Abstract: We present new evidence on the relationship between health behaviors and experimental measures of risk and time preferences and introduce evidence that perceived control — a measure incorporated from the health psychology literature — is a stronger and more consistent predictor of health behaviors than economic preferences.
    Keywords: Health ; Human behavior
    Date: 2012
  6. By: Mariacristina De Nardi; Eric French; John Bailey Jones
    Abstract: Medicaid was primarily designed to protect and insure the poor against medical shocks. Yet, poorer people tend to live shorter lifespans and incur lower medical expenses before death than richer people. Taking these and other important dimensions of heterogeneity into account, and carefully modeling key institutional aspects, we estimate a structural model of savings and endogenous medical expenses to assess the costs and benefits of Medicaid for single retirees. ; We show that even higher-income retirees benefit from Medicaid, if they live long enough for their resources to be depleted by medical expenses. We also find that all retirees value Medicaid insurance coverage highly, compared to the value of the Medicaid transfers that they actually receive on average.
    Date: 2012
  7. By: Douglas Almond; Bhashkar Mazumder
    Abstract: We review the literature on how parental investments respond to health endowments at birth. Recent studies have combined insights from an earlier theoretical literature on how households allocate resources within the family, with a growing empirical literature that identifies early life health shocks using sharp research designs. We describe the econometric challenges in identifying the behavioral responses of parents and how recent studies have sought to address these challenges. We also discuss the emerging literature that has considered how there may be dynamic complementarities in parental investments due to the developmental nature of human capital production and how there may be multiple dimensions of skill. We find that thus far, the bulk of the empirical evidence is consistent with the notion that parents reinforce initial endowments.
    Date: 2012
  8. By: Lindgren, Karl-Oskar (IFAU - Institute for Evaluation of Labour Market and Education Policy)
    Abstract: This study examines how workplace size relates to transitions in- and out-of sickness absence. Overall, the study finds important differences in the long-term sickness absence behavior of individuals working in small and large workplaces. In particular, the results show that the sickness spells are of higher incidence, but somewhat shorter duration in large workplaces. However, the results also show that the strength of these relationships varies across different labor market groups. The analysis is based on rich administrative data from Sweden over the period 1994–2008.
    Keywords: Sickness absence; workplace size; hazard model
    JEL: J22 J23
    Date: 2012–12–13
  9. By: Tom Bundervoet (the International Rescue Committee)
    Abstract: This article examines the impact of war-induced ill early childhood health on educational attainment in early adolescence. Using data on a small panel of children we find that children who were malnourished at baseline had on average attained fewer grades than children of the same year of birth cohort who were healthier at baseline. The effect is particularly salient for the older children who were most exposed to violence in their early childhood years. We find that the worse educational status of malnourished children is due to both an enrolment effect and a poor school performance effect.
    Keywords: childhood, health, education, nutrition, Burundi
    Date: 2012–04
  10. By: Camelia Minoiu (International Monetary Fund IMF Institute); Olga N. Shemyakina (Georgia Institute of Technology School of Economics)
    Abstract: We examine the effect of the 2002-2007 civil conflict in Côte d'Ivoire on children's health status using household surveys collected before, during, and after the conflict, and information on the exact location and date of conflict events. Our identification strategy relies on exploiting both temporal and spatial variation across birth cohorts to measure children's exposure to the conflict. We find that children from regions more affected by the conflict suffered significant health setbacks compared with children from less affected regions. We further examine possible war impact mechanisms using rich data on households' experience of war from the post-conflict survey. Our results suggest that conflict-induced economic losses, health impairment, displacement, and other forms of victimization are important channels through which conflict negatively impacts child health.
    Keywords: child health, conflict, height-for-age, sub-Saharan Africa
    Date: 2012–08
  11. By: Maren M. Michaelsen (Ruhr University Bochum, Faculty of Economics)
    Abstract: In Mexico, conflicts between drug-trafficking organisations result in a high number of deaths and immense suffering among both victims and non-victims every year. Little scientific research exists which identifies and quantifies the monetary and nonmonetary consequences of ongoing violent conflicts on individuals. Using the Mexican Family Life Survey for 2002 and 2005, the causal effect of mental health (symptoms of depression / anxiety) on the extensive and intensive margin of labour supply for workingaged men and women is estimated. Measures of the ongoing drug-related violent conflicts both at the macro level using intentional homicide rates by region, and at the micro level indicated by the presence of armed groups in the neighbourhood, serve as instruments for mental health. The results show a significant adverse impact of the conflicts on anxiety for men and women. Based on IV-Tobit model results, a worse mental health state decreases individual labour supply strongly and significantly for men. The findings demonstrate that Mexico's population not only suffers from the violent conflicts between drug-trafficking organisations by anxiety or even depression but also indirectly from less household income through less work which in turn has consequences for Mexico's social development and economic growth.
    JEL: J22 I19 O12 D74
    Date: 2012–08
  12. By: Laszlo Goerke (Institute for Labour Law and Industrial Relations in the EU, University of Trier); Markus Pannenberg
    Abstract: In 1996, statutory sick pay was reduced for private sector workers in Germany. Using the empirical observation that trade union members are dismissed less often than non-members, we construct a model to predict how absence behaviour will respond to the sick pay reform. We show that union members may have stronger incentives to be absent and to react to the cut in sick pay. In the empirical investigation, we find a positive relationship between trade union membership and absence due to sickness and observe more pronounced reactions to the cut in sick pay among union members than among non-members. These findings suggest that more flexibility in the use of paid absence due to sickness constitutes a private gain from trade union membership.
    Keywords: difference-in-differences, sickness-related absence, Socio-Economic Panel (SOEP), statutory sick pay, trade union membership
    JEL: I18 J51 J22
    Date: 2012–10
  13. By: Daniel Arnold (Institute for Labour Law and Industrial Relations in the EU, University of Trier)
    Abstract: This paper analyzes the impact of a country’s level of benefit morale on generosity of sick pay entitlements by means of a political economy model and an empirical investigation. Higher benefit morale reduces the incidence of absence. On the one hand, this makes insurance cheaper with the usual demand side reaction. On the other hand, being absent less often, the voter prefers less insurance. The former effect dominates at lower, the latter at higher levels of benefit morale. We present empirical evidence for both effects in a sample of 31 countries between 1981 and 2010.
    Keywords: sick pay insurance, political economy, work absence, social norms
    JEL: H53 P16 Z13
    Date: 2012–12
  14. By: Albane Tarnaud (IESEG School of Management (LEM-CNRS)); Hervé Leleu (CNRS-LEM and IESEG School of Management); David Crainich (CNRS-LEM and IESEG School of Management)
    Keywords: Data envelopment analysis; Risk management; Investment analysis
    JEL: D81 C44
    Date: 2012–12
  15. By: António Afonso; João Tovar Jalles
    Abstract: We use a panel of developed and emerging countries for the period 1970-2008 to assess the cyclicality of education, health, and social security government spending. We mostly find acyclical behaviour, but evidence also points to counter-cyclicality for social security spending, particularly in OECD countries, consistent with the operation of automatic stabilizers. JEL Classification: C23, E62, H50.
    Keywords: business cycle, output gap, functional spending, panel analysis.
    Date: 2012–09
  16. By: Felipa de Mello-Sampayo; Sofia de Sousa Vale
    Abstract: As apresentações habituais do modelo Hecksher-Ohlin (HO) nos livros de texto têm quatro problemas: análise por vezes superficial dos mecanismos económicos relevantes; escassa ilustração através de exemplos económicos concretos da capacidade explicativa do modelo; utilização de análises matemática e sobretudo gráfica frequentemente desnecessárias; e utilização da hipótese, muito discutível, de que a remuneração de um factor é determinada pela sua produtividade marginal – opção que acaba por afastar a discussão da realidade económica concreta. Estes problemas – designadamente, a ênfase na análise formal e o défice de análise económica e de exemplos ilustrativos - conferem um “sabor artificial” ao modelo HO, tornando-o pouco credível. O presente artigo pretende dar um contributo para a resolução deste problema, apresentando uma exposição do modelo HO diferente das habituais nos livros de texto. São de destacar os seguintes contributos: i) a precisão da noção de “preço do capital”; ii) o esclarecimento da noção de abundância de capital; iii) a recuperação de exemplos do texto clássico de Ohlin muito elucidativos a respeito da capacidade explicativa do teorema HO; iv) uma possível explicação para o paradoxo de Leontieff; v) a ilustração do efeito da especialização sobre os preços relativos dos factores e dos bens com base em gráficos diferentes dos habituais; vi) uma explicação para a origem dos ganhos do comércio diferente da tradicional; vii) a discussão do efeito do comércio sobre o rendimento real dos factores sem a utilização da hipótese – muito discutível - de que a remuneração de um factor é determinada pela sua produtividade marginal; viii) a discussão do efeito que o comércio e o progresso técnico terão tido sobre a evolução dos salários reais de trabalhadores americanos com diferentes níveis de qualificação desde 1979; ix) por último, a explicação do teorema de Rybczynski a partir de um exemplo concreto: o aprofundamento da especialização portuguesa em têxteis, vestuário e calçado na década a seguir ao 25 de Abril de 1974. JEL Classification: C33; H51; I10;
    Keywords: Health Expenditure; Drivers of Health Expenditure; Panel Unit Root Tests; Panel Cointegration; Cross Section Dependence model.
    Date: 2012–09
  17. By: Seth Freedman (Indiana University); Haizhen Lin (Department of Business Economics and Public Policy, Indiana University Kelley School of Business); Kosali Simon (Indiana University and NBER)
    Abstract: This paper explores the effects of public health insurance expansions on hospitals’ decisions to adopt medical technology. Specifically, we test whether the expansion of Medicaid eligibility for pregnant women during the 1980s and 1990s affected hospitals’ decisions to adopt neonatal intensive care units (NICUs). While the Medicaid expansion insured a substantial number of pregnant women who would otherwise have been uninsured, prior literature also finds that some newly insured women would otherwise have been covered by more generously-reimbursed private sources. This leads to a theoretically ambiguous net effect of Medicaid expansion on a hospital’s incentive to invest in technology. Using American Hospital Association (AHA) data, we find that on average Medicaid expansions had no statistically significant effect on NICU adoption. However, we find that in geographic areas where more of the newly Medicaid-insured may have come from the privately insured population, Medicaid expansion slowed NICU adoption. This holds true particularly when Medicaid payment rates were very low relative to private payment rates. Our findings suggest that despite the fact that on average Medicaid expansions did not affect the proliferation of NICUs in the 1980s and 1990s, the Medicaid-induced shifts from private to public coverage slowed NICU adoption. This finding is consistent with prior evidence on reduced NICU adoption from increased managed care penetration. We conclude by providing suggestive evidence on the health impacts of this deceleration of NICU diffusion, and by discussing the policy implications of our work for insurance expansions associated with the Affordable Care Act.
    Date: 2012–10
  18. By: Gobillon, Laurent (INED, France); Milcent, Carine (Paris School of Economics)
    Abstract: Mortality differences between university, non-teaching public and for-profit hospitals are investigated using a French exhaustive administrative dataset on patients admitted for heart attack. Our results show that innovative procedures play a key role in explaining the effect of ownership status on hospital quality. When age, sex, diagnoses and co-morbidities are held constant, the mortality rates in for-profit and university hospitals are similar, but they are lower than in public non-teaching hospitals. When additionally controlling for innovative procedures, the mortality rate is higher in for-profit hospitals than in the two groups of public hospitals. This suggests that the quality of care in for-profit hospitals relies on innovative procedures and that, after controlling for case-mix and innovative treatments, there is a better quality of care in public hospitals.
    Keywords: hospital performance, innovative procedures, stratified duration model, hospital quality
    JEL: I12 I18
    Date: 2012–12
  19. By: Perry Singleton (Center for Policy Research, Maxwell School, Syracuse University, Syracuse, NY 13244-1020)
    Abstract: This study measures the effect of disability insurance on labor supply and health insurance coverage. The effect is identified by a policy in 1990 that increased the generosity of Social Security’s disabled-widow program. Using data from the Current Population Survey, the results suggest that, in this context, disability benefits led to a one-to-one decline in labor force participation, employment, and private insurance coverage. The results imply that the demand for disability benefits may not reflect a latent demand for public health insurance. Key Words: disability insurance, health insurance, labor force participation, Social Security, widows JEL No. H55, J20
    Date: 2012–10
  20. By: Alejandro Arrieta (Indiana University School of Medicine Department of Public Health); Ariadna García-Prado Author-Email: (Departamento de Economía-UPNA)
    Date: 2012
  21. By: Alejandro Arrieta; Ariadna García Prado (Departamento de Economía-UPNA); Giota Panopoulou
    Abstract: We assess the impact that Colombia’s 1993 health sector reform had on the enrollment of self-employed workers in mandatory social health insurance scheme, with a especial focus on the independent contractors. This group grew dramatically in the form of workers cooperatives between 1993 and 2003, becoming a source of self-employed evasion and a way to disguised employment. We use two national-level Living Standards Measurement Surveys conducted in Colombia in 1997 and 2003, and follow a methodology that corrects for sample selection, decomposing health insurance coverage variation into changes attributed to the reform and to the characteristics of independent contractors. We find that: (i) Between 1997 and 2003, enrollment increased in 28 percentage points reaching an insurance rate of 62%, still below the reform goal of 80%, (ii) enrollment of independent contractors in 1997 was only 35% (compared to 50%) after adjusting by the selection bias due to disguised employment, (ii) the new legislation and stringent monitoring implemented in 2003 to cope with evasion seem to be effective since the sample selection due to disguised employment was not statistically significant in 2003. Addressing the interaction of the labor market with the health reform, as well as, accounting for the heterogeneity within the self-employed group are the main contributions of this paper to the literature on health insurance reforms in developing countries.
    Keywords: Self-employed, worker cooperatives, health insurance, Colombia.
    JEL: D24 I12 I18
    Date: 2012
  22. By: Victor Iajya; Nicola Lacetera; Mario Macis; Robert Slonim
    Abstract: In many low- and middle-income countries blood donations per capita are substantially lower than in advanced economies. In these countries blood supply is mostly collected through donations by relatives and friends of individuals needing transfusions or to replace blood used in emergencies. The World Health Organization considers this method of blood supply inefficient compared to undirected voluntary donations. To examine methods to motivate undirected voluntary donations, we ran a large-scale, natural field experiment in Argentina testing the effectiveness of information, social and economic incentives. We find that only higher-valued economic incentives generated more donations, increasing in the value of the incentive. These incentives did not create adverse selection in the safety and usability of the donated blood. We discuss the implications of our findings for researchers interested in understanding motivations for pro-social behavior and for health agencies and policymakers concerned with the current and growing shortages in blood supply in low- and middle-income countries.
    JEL: C93 D03 H41 I15
    Date: 2012–12
  23. By: Jason Fletcher; Barbara L. Wolfe
    Abstract: There have been numerous attempts to both document the income-health gradient in children and to understand the nature of the tie. In this paper we review and summarize existing studies and then use a unique school based panel data set from the US to attempt to further our understanding of the relationship. The long duration (5 observations, 9 years) allows us to add to the understanding of the pattern of the tie, through our ability to test for changes in health status and multiple measures of income, and the school-based nature of the data allow us to add community SES to the model. Increasing understanding of the income-health gradient may allow more effective targeting of interventions to decrease the gradient and hence decrease health disparities among children.
    JEL: I1 I12 I14 I3
    Date: 2012–12
  24. By: Michael Grossman; Erdal Tekin; Roy Wada
    Abstract: We examine the effects of fast-food restaurant advertising on television on the body composition of adolescents as measured by percentage body fat (PBF) and to assess the sensitivity of these effects to using conventional measures of youth obesity based on body-mass index (BMI). We merge measures of body composition from bioelectrical-impedance analysis (BIA) and dual-energy x-ray absorptiometry (DXA) from the National Health and Nutrition Examination Survey with individual level data from the National Longitudinal Survey of Youth 1997 and data on local fast-food restaurant advertising on television from Competitive Media Reporting. Exposure to fast-food restaurant advertising on television causes statistically significant increases in PBF in adolescents. These results are consistent with those obtained by using BMI-based measures of obesity. The responsiveness to fast-food advertising is greater for PBF than for BMI. Males are more responsive to advertising than females regardless of the measure. A complete advertising ban on fast-food restaurants on television would reduce BMI by 2 percent and PBF by 3 percent. The elimination of the tax deductibility of food advertising costs would still leave a considerable number of youth exposed to fast-food advertising on television but would still result in non-trivial reductions in obesity.
    JEL: I10 I18
    Date: 2012–12
  25. By: Aviva Aron-Dine; Liran Einav; Amy Finkelstein
    Abstract: We re-present and re-examine the analysis from the famous RAND Health Insurance Experiment from the 1970s on the impact of consumer cost sharing in health insurance on medical spending. We begin by summarizing the experiment and its core findings in a manner that would be standard in the current age. We then examine potential threats to the validity of a causal interpretation of the experimental treatment effects stemming from different study participation and differential reporting of outcomes across treatment arms. Finally, we re-consider the famous RAND estimate that the elasticity of medical spending with respect to its out-of-pocket price is -0.2, emphasizing the challenges associated with summarizing the experimental treatment effects from non-linear health insurance contracts using a single price elasticity.
    Date: 2012–12
  26. By: James M. Poterba; Steven F. Venti; David A. Wise
    Abstract: Social Security benefits are the most important component of the income of a large fraction of older Americans. A significant fraction of persons approach the end of life with few financial assets and no home equity, relying almost entirely on Social Security benefits for support. Whether persons reach late-life with positive non-annuity wealth depends importantly on health, which is quite persistent over the life-time. Persons in poor health in old age have a higher-than-average probability of having experienced low earnings while in the labor force, which puts them at greater risk of having low Social Security benefits in retirement. While the progressivity of the Social Security benefit formula provides a safety net to support low-wage workers in retirement, a noticeable fraction of persons, especially those in single-person households, still have income below the poverty level in their last years of life. Many of these individuals have few assets to draw on to supplement their income, and are in poor health. In general, low assets and low income in old age are strongly related to poor health. We explore this nexus and describe the relationship between Social Security benefits and the exhaustion of non-annuity assets near the end of life. We examine the relationship between the drawdown of assets between the first year an individual is observed in the AHEAD data (1995) and the last year that individual is observed before death, and that individual's health, Social Security benefits, and other annuity benefits. We conclude that Social Security and defined benefit pension benefits are strongly “protective” of non-annuity assets, with a negative relationship between these income flows and the likelihood of exhausting non-annuity assets. We also find that poor health is an important determinant of the drawdown of non-annuity wealth.
    JEL: H55 I14
    Date: 2012–12
  27. By: Sandra E. Black; Paul J. Devereux; Kjell G. Salvanes
    Abstract: Job reallocation is considered to be a key characteristic of well-functioning labor markets, as more productive firms grow and less productive ones contract or close. However, despite its potential benefits for the economy, there are significant costs that are borne by displaced workers. We study how job displacement in Norway affects cardiovascular health using a sample of men and women who are predominantly aged in their early forties. To do so we merge survey data on health and health behaviors with register data on person and firm characteristics. We track the health of displaced and non-displaced workers from 5 years before to 7 years after displacement. We find that job displacement has a negative effect on the health of both men and women. Importantly, much of this effect is driven by an increase in smoking behavior. These results are robust to a variety of specification checks.
    JEL: I10 J63
    Date: 2012–12
  28. By: Laporte, Audrey; Berchet, Caroline
    Abstract: Using a representative longitudinal survey of the immigrant population in Canada (the "Longitudinal Survey of Immigrants in Canada"), this article assesses the causal influence of social capital (as measured by social participation) on immigrant health status and health care use. Furthermore, it sheds light on the relationship existing between social capital, human capital and immigrant health conditions. We begin with Probit models but then address the identification issue of social capital using several bivariate dynamic Probit models. Estimation results are consistent with exiting literature since we nd a positive in uence of social participation on immigrant health status and health care use. Moreover, our analyses reveal that some social activities are more protective than others such as participation to sporting groups, church groups, cultural clubs or political associations. More importantly, the effect of social capital on immigrant health conditions seems to differ according to their human capital level, measured through educational attainment. In this respect, social capital appears to act as a substitute for human capital to enhance immigrant health status while we found a complementary effect between social and human capital to increase immigrant health care utilisation.
    Keywords: Immigrant health status; health care use;
    JEL: I38 I12 O15
  29. By: Pieters, A.; Oorschot, K.E. van (Tilburg University); Akkermans, H.A. (Tilburg University)
    Date: 2012
  30. By: Chakraborty, Lekha (National Institute of Public Finance and Policy); Singh, Yadawendra; Jacob, Jannet Farida
    Abstract: Effectiveness of public spending still remains relatively an elusive empirical issue. This preliminary analysis is an attempt on the topic, using benefit incidence methodology, at the subnational government level in health sector of India. The results revealed public health system is `seemingly' more equitable in a few States, while a regressivity in pattern of utilization of public health care services is observed in other States. Both these evidences were to be considered with caution, as the underdeveloped market for private inpatient care in some states might be the factor for disproportionate crowding-in of inpatients, which made the public health care system looked `seemingly' more equitable. However, the `voting with feet' to better private services seems evident only for the affordable higher income quintiles. Results also suggest that polarization is distinctly evident in the public provisioning of heath care services, more related to the in-patient services than the ambulatory services.
    Keywords: Effectiveness of public spending ; Benefit incidence
    JEL: H51 H75 I14
    Date: 2012–12
  31. By: Yousuf, Ahmed Sadek
    Abstract: This paper examines the relationship between health aid and infant mortality, using data from in total 135 countries (for the purposes of this study, developing countries), between 1975 and 2010. Utilizing both conventional Instrumental Variable and System GMM approaches, a tentative conclusion can be drawn that aid comes to have a statistically significant and positive effect on infant mortality rate, as doubling of aid leads to an approximately 1.3% reduction in infant mortality rates. Thus for an average aid recipient country, doubling per capita aid leads to a reduction of about 790 deaths per million live births in a particular year. This effect, in comparison to the set goals of the Millennium Development Goals, is small and may not be enough to ensure that the MDG targets are met by 2015.
    Keywords: Health Oriented Aid; Instrumental Variable; System GMM; Infant Mortality Rates
    JEL: C23 C33 C01 I10
    Date: 2012–10–12
  32. By: Lagravinese, Raffaele; Paradiso, Massimo
    Abstract: The vulnerability of health sector to corruption lies in the complex interaction between the social environment and the institutional setting of health systems. We investigate this interaction in the case of Italy, speci…cally looking at the impact of corruption on health expenditure. In Italy corruption is a social phenomenon. Health sector has been often involved in corruption o¤ences and decentralized health expenditure is considerably out of control. We show that the impact of corruption on health expenditure is positive, along with ageing population, technological change and supply factors inducing demand in pharmaceuticals and hospitalization. Moreover, the empirical analysis demonstrates that corruption a¤ects pharmaceutical expenditure and accredited private hospital expenditure, suggesting implications for health governance and policy.
    Keywords: health expenditures; corruption; panel data; sur model
    JEL: H51 H75 K14
    Date: 2012–12–02
  33. By: Fioriti, Linda; Marchini, Andrea; Diotallevi, Francesco; Pampanini, Rossella
    Abstract: After a deep review of the main economic studies and applications about the emerging problem of obesity, this paper focuses on a particular aspect of the issue: the improvement of fruit and vegetable purchasing in retailing sector. First of all it has been analyzed the actual presence of strategies aimed at improving fruit and vegetable consumption in the main retailing companies operating in Italy. Then the study investigates the role of price in consumers’ purchasing choices. High price elasticity of F&V products could suggest the implementation of lower prices to consumers instead of implementing other policy interventions. The methodology is based on qualitative and quantitative research methods. In particular, in depth interviews to retailing sector experts have been run to gather useful insights about retailers’ management of F&V department. Then quantitative analysis on IRI data about F&V consumption in Italy has been conducted to evaluate the influence of price on consumers’ attitude towards F&V. The results obtained provide meaningful insights to formulate marketing strategies and policy interventions.
    Keywords: Obesity; fruit and vegetables; consumer behaviour; food promotion
    JEL: Q13 Q18
    Date: 2012–02–12
  34. By: Colombier, Carsten
    Abstract: According to Baumol (1993) health care epitomises Baumol's cost disease. Sectors that suffer from Baumol's cost disease are characterised by slow productivity growth due to a high labour coefficient. As a result, unit costs of these sectors rise inexorably if the respective wages increase with productivity growth of the progressive industries such as manufacturing. Thus, according to Baumol (1993) the secular rise in health-care expenditure has been unavoidable. This present paper demonstrates that health care is contracted by Baumol's cost disease, but only to a minor extent. Consequently, policy-makers have more leeway to curbever-increasing health-care expenditure than is suggested by Baumol (1993) and other authors. In addition, we test the implications of Baumol's cost disease for health care by avoiding the well-known flaws in constructing medical price indices. Therefore, the adjusted Baumol variable derived in this paper is also extremely appropriate to test the validity of Baumol's cost diseases of other service industries such as education or the live performing arts. Additionally, our analysis suggests that health care is rather a necessity than a luxury at the national level, which conflicts with macroeconomic evidence provided in the relevant literature. --
    Keywords: health-care expenditure,Baumol's cost disease,the macroeconomics of health care,the adjusted Baumol variable
    JEL: C23 H51 I10
    Date: 2012

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