nep-hea New Economics Papers
on Health Economics
Issue of 2013‒02‒03
ten papers chosen by
Yong Yin
SUNY at Buffalo

  1. Losing Heart? The Effect of Job Displacement on Health By Black, Sandra E.; Devereux, Paul J.; Salvanes, Kjell G.
  2. A Cross-Country Analysis of Health Care Expenditures By Alex R. Horenstein; Manuel S. Santos
  3. Income Eligibility for Assistance Under the Affordable Care Act: Technical Memorandum on Estimates for Nonelderly Adults. Washington, DC: Mathematica Policy Research By John L. Czajka
  4. Air Pollution and Infant Mortality: Evidence from the Expansion of Natural Gas Infrastructure By Resul Cesur; Erdal Tekin; Aydogan Ulker
  5. The Development of Long-Term Care in Post-Socialist Member States of the EU By Stanislawa Golinowska; Agnieszka Sowa
  6. Egalitarianism and Altruism in Health: To What Extent Are They Related? By Ignacio Abásolo; Aki Tsuchiya
  7. How subjective beliefs about HIV infection affect life-cycle fertility : evidence from rural Malawi By Shapira, Gil
  8. Children's health opportunities and project evaluation : Mexico's Oportunidades program By Van de gaer, Dirk; Vandenbossche, Joost; Figueroa, Jose Luis
  9. Is foreign aid fungible ? evidence from the education and health sectors By Van de Sijpe, Nicolas
  10. Estimating Heterogeneous Take-up and Crowd-Out Responses to Current Medicaid Limits and Their Nonmarginal Expansions By Lara Shore-Sheppard; John Ham; Serkan Ozbeklik

  1. By: Black, Sandra E. (University of Texas at Austin); Devereux, Paul J. (University College Dublin); Salvanes, Kjell G. (Norwegian School of Economics (NHH))
    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.
    Keywords: job loss, health, health behavior
    JEL: I18 C14 J64 J65
    Date: 2012–12
  2. By: Alex R. Horenstein (School of Business, ITAM); Manuel S. Santos (Department of Economics, University of Miami)
    Abstract: This paper is concerned with growth patterns of US health care expenditures. Within a representative sample of OECD countries, we lay out a growth accounting exercise for health care expenditures to assess the influence of several explanatory variables. Our analysis demonstrates that the relative price of medical care and some health care laws can trace down fairly well the differential increase in US medical expenditures over the period 1970-2007. We then explore some major factors driving US medical care prices - including prescription drugs, the degree of competition, malpractice, and out-of-pocket expenditures. Some other explanatory variables - income growth, technological change, life expectancy, physicians' compensation, trends in aging population, and defensive medicine - would seem unable to account for the differential increase in US medical expenditures over various time periods.
    Keywords: Health care expenditures, relative price of medical care, growth accounting, price elasticity, technological change, malpractice
    JEL: I10 I11 I18 E31
    Date: 2012–12–29
  3. By: John L. Czajka
    Keywords: Income Eligibility, Affordable Care Act; ACA, Nonelderly Adults, Health
    Date: 2013–01–30
  4. By: Resul Cesur; Erdal Tekin; Aydogan Ulker
    Abstract: One of the consequences of rapid economic growth and industrialization in the developing world has been deterioration in environmental conditions and air quality. While air pollution is a serious threat to health in most developing countries, environmental regulations are rare and the determination to address the problem is weak due to ongoing pressures to sustain robust economic growth. Under these constraints, natural gas, as a clean, abundant, and highly-efficient source of energy, has emerged as an increasingly attractive source of fuel, which could address some of the environmental and health challenges faced by these countries without undermining their economies. In this paper, we examine the impact of air pollution on infant mortality in Turkey using variation across provinces and over time in the adoption of natural gas as a cleaner fuel. Our results indicate that the expansion of natural gas infrastructure has caused a significant decrease in the rate of infant mortality in Turkey. In particular, a one-percentage point increase in the rate of subscriptions to natural gas services would cause the infant mortality rate to decline by 4 percent, which could result in 348 infant lives saved in 2011 alone. These results are robust to a large number of specifications. Finally, we use supplemental data on total particulate matter and sulfur dioxide to produce direct estimates of the effects of these pollutants on infant mortality using natural gas expansion as an instrument. Our elasticity estimates from the instrumental variable analysis are 1.25 for particulate matter and 0.63 for sulfur dioxide.
    JEL: I0 I12 I15 I18 O10 O13 Q42 Q48 Q53
    Date: 2013–01
  5. By: Stanislawa Golinowska; Agnieszka Sowa
    Abstract: Long-term care (LTC) in the new EU member states, which used to belong to the former socialist countries, is not yet a legally separated sector of social security. However, the ageing dynamics are more intensive in these states than in the old EU member states. This paper analyses the process of creating an LTC sector in the context of institutional reforms of social protection systems during the transition period. The authors explain LTC’s position straddling the health and social sectors, the underdevelopment of formal LTC, and the current policies regarding the risk of LTC dependency. The paper is based mainly on the analysis of information provided by country experts in the ANCIEN project.
    Keywords: Labor market, social policy and social services, Europe, long-term care, social sector reform, social policy
    JEL: I18 I31 J11 J18
    Date: 2013–01
  6. By: Ignacio Abásolo (Departamento de Economía de las Instituciones, Estadística y Econometría, Facultad de Ciencias Económicas y Empresariales. Universidad de La Laguna, Campus de Guajara. Tenerife. Spain); Aki Tsuchiya (Department of Economics, The University of Sheffield)
    Abstract: The theoretical constructs of egalitarianism and altruism are different from each other, yet there may be associations between the two at the empirical level. This paper explores the empirical relationship between egalitarianism and altruism, in the context of health. A representative sample of the Spanish population was interviewed in 2004 (n=801). We specify a model that explains the propensity of an individual to be egalitarian in terms of altruism and other background characteristics. In this paper, individuals who prefer a hypothetical policy that reduces inequality in health outcomes over another that does not are regarded ‘egalitarian’. 'Altruism' in the health context is captured by whether or not the same respondents are (or have been) regular blood donors, provided they are medically able to donate. Probit models are specified to estimate the relationship between egalitarianism and altruism, thus defined. Overall, 75% of respondents are found to be egalitarians, whilst 34% are found to be altruists. We find that, once controlled for background characteristics, there is a statistically significant empirical relationship between egalitarianism and altruism in the health context. In particular, altruist individuals have an 11% higher probability to be egalitarians than those who are not.
    Keywords: egalitarism; altruism; health
    Date: 2013
  7. By: Shapira, Gil
    Abstract: This paper studies the effect of subjective beliefs about HIV infection on fertility decisions in a context of high HIV prevalence and simulates the impact of different policy interventions, such as HIV testing programs and prevention of mother-to-child transmission, on fertility and child mortality. It develops a model of women's life-cycle, in which women make sequential fertility decisions. Expectations about the life horizon and child survival depend on women's perceived exposure to HIV infection, which is allowed to differ from the actual exposure. In the model, women form beliefs about their HIV status and about their own and their children's survival in future periods. Women update their beliefs with survival to each additional period as well as when their HIV status is revealed by an HIV test. Model parameters are estimated by maximum likelihood with longitudinal data from the Malawi Diffusion and Ideational Change Project, which contain family rosters, information on HIV testing, and measures of subjective beliefs about own HIV status. The model successfully fits the fertility patterns in the data, as well as the distribution of reported beliefs about own HIV status. The analysis uses the model to assess the effect of HIV on fertility by simulating behavior in an environment without HIV. The results show that the presence of HIV reduces the average number of births a woman has during her life-cycle by 0.15. The paper also finds that HIV testing can reduce the fertility of infected women, leading to a reduction of child mortality and orphan-hood.
    Keywords: Population Policies,Gender and Health,Disease Control&Prevention,Gender and Law,Adolescent Health
    Date: 2013–01–01
  8. By: Van de gaer, Dirk; Vandenbossche, Joost; Figueroa, Jose Luis
    Abstract: This paper proposes a methodology to evaluate social projects from the perspective of children's opportunities on the basis of the effects of these projects on the distribution of outcomes. The evaluation is conditioned on characteristics for which individuals are not responsible; in this case, parental education level and indigenous background. The methodology is applied to evaluate the effects on children's health opportunities of Mexico's Oportunidades program, one of the largest conditional cash transfer programs for poor households in the world. The evidence from this program shows that gains in health opportunities for children from indigenous backgrounds are substantial and are situated in crucial parts of the distribution, whereas gains for children from nonindigenous backgrounds are more limited.
    Keywords: Health Monitoring&Evaluation,Disease Control&Prevention,Gender and Law,Primary Education,Street Children
    Date: 2013–01–01
  9. By: Van de Sijpe, Nicolas
    Abstract: This paper adopts a new approach to the issue of foreign aid fungibility. In contrast to most existing empirical studies, panel data are employed that contain information on the specific purposes for which aid is given. This allows linking aid that is provided for education and health purposes to recipient public spending in these sectors. In addition, aid flows that are recorded on a recipient's budget are distinguished from those that are not recorded on budget, and the previous failure to differentiate between on- and off-budget aid is shown to produce biased estimates of fungibility. Sector program aid is the measure of on-budget aid, whereas technical cooperation serves as a proxy for off-budget aid. The appropriate treatment of off-budget aid leads to lower fungibility estimates than those reported in many previous studies. Specifically, in both sectors and across a range of specifications, technical cooperation, which is the largest component of total education and health aid, leads to, at most, a small displacement of recipient public expenditures.
    Keywords: Health Monitoring&Evaluation,Gender and Health,Public Sector Expenditure Policy,Disability,Debt Markets
    Date: 2013–01–01
  10. By: Lara Shore-Sheppard (Williams College); John Ham (University of Maryland); Serkan Ozbeklik (Claremont McKenna College)
    Abstract: We use a switching probit model and the income-limit-based structure of Medicaid eligibility for children to estimate treatment effects of Medicaid expansions not found in existing work on public insurance. In particular, we estimate rates of Medicaid take-up, private insurance coverage, and crowd-out for the currently eligible overall and for different demographic groups, and we estimate corresponding rates for children made eligible by a counterfactual nonmarginal increase in the Medicaid income limits. We find strikingly different rates across demographic groups, with individuals in traditionally less disadvantaged groups having a considerably lower response to the coverage for which they are eligible.
    Keywords: Medicaid expansions, take-up, crowd-out, treatment effects, switching probit model, counterfactual policy analysis
    Date: 2012–11

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