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on Health Economics |
| By: | Claudia Keser; Claude Montmarquette; Martin Schmidt; Cornelius Schnitzler |
| Abstract: | In this paper, we investigate in a controlled laboratory experiment physician behavior in the case of payment heterogeneity. In the experiment, each physician provides medical care to patients whose treatments are paid for either under fee-for-service (FFS) or capitation (CAP). We observe that physicians customize care in response to the payment system. A FFS patient receives considerably more medical care than the corresponding CAP patient with the same illness and treatment preference. Physicians over-serve FFS patients and under-serve CAP patients. After a CAP payment reduction in the experiment we observe neither a quantity reduction under CAP nor a spillover into the treatment of FFS patients. <P> |
| Keywords: | Experimental Economics, Physician Reimbursement, Capitation, FFS, Customization, Fee Regulation, |
| JEL: | I12 I18 |
| Date: | 2013–06–01 |
| URL: | http://d.repec.org/n?u=RePEc:cir:cirwor:2013s-15&r=hea |
| By: | Norma B. Coe; Stephan Lindner; Kendrew Wong; April Yanyuan Wu |
| Abstract: | The wait time for a Social Security Disability Insurance (SSDI) award varies from a few months to several years. Little is known about how applicants fund their consumption during this period. Using the Survey of Income and Program Participation (SIPP) linked to the Social Security Administration’s 831 file, this study examines the use of seven different coping strategies on which applicants may rely for resources, including government transfers, intra-family resources, other financial resources, and locational changes. Our results suggest that applicants use some coping strategies more frequently with longer application duration, especially spousal employment, the Supplemental Nutrition Assistance Program (SNAP) and the Supplemental Security Income (SSI) program for the disabled and children. They are also less likely to report receiving Unemployment Insurance benefits, changing their address, and owning a home. Together, these results suggests that some of the studied coping strategies are an important part of funding consumption during the application process, either by sustaining ongoing applications or by making it easier to file an appeal of an initially denied application. |
| Date: | 2013–06 |
| URL: | http://d.repec.org/n?u=RePEc:crr:crrwps:wp2013-12&r=hea |
| By: | Guardado, José R. (American Medical Association); Ziebarth, Nicolas R. (Cornell University) |
| Abstract: | In this paper, we develop a theoretical model of worker investment in safety. Standard theory assumes that injury risk is exogenous. It predicts that riskier jobs are associated with higher wages. In contrast, in our model, workers make individual safety investments that reduce the risk of injury. This results in a negative association between individual injury risk and wages. We test the model's predictions using obesity as a proxy for worker disinvestments in human capital and safety. In line with our model predictions, we find a significant positive compensating wage differential (CWD) for nonfatal risk at the occupational level. At the same time, however, there exists an underlying significant negative association between individual accident risk and wages, but only in high risk occupations. The latter relationship may downward bias or mask CWD estimates. |
| Keywords: | worker investment, safety, nonfatal risk, compensating wage differential, obesity |
| JEL: | I10 I12 J24 J31 J62 J71 |
| Date: | 2013–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp7428&r=hea |
| By: | Delaney, Jason J. (Georgia Gwinnett College); Winters, John V. (University of Cincinnati) |
| Abstract: | This paper examines parental influence on adolescent risky behavior, focusing on a unique population: children of the clergy, more commonly known as preachers' kids (PKs). We use latent variable and zero-inflated count models to analyze the effect of being a PK on both uptake and intensity of use of alcohol, cigarettes, marijuana, and other drugs. We find that being a PK significantly reduces alcohol use. This effect comes exclusively from a reduction in the probability of any alcohol use and this increased abstinence among children of the clergy persists into adulthood. These results are consistent with popular conceptions that PKs either take no risks or take large risks. We find no significant effects of being a PK on cigarette uptake or intensity of use but some evidence of a negative PK effect on the uptake of marijuana and other drugs. |
| Keywords: | preacher's kid, religion, risky behavior, alcohol, tobacco, substance use |
| JEL: | I19 J13 K42 Z12 |
| Date: | 2013–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp7434&r=hea |
| By: | Max Groneck; Alexander Ludwig; Alexander Zimper |
| Abstract: | On average, "young" people underestimate whereas "old" people overestimate their chances to survive into the future. We adopt a Bayesian learning model of ambiguous survival beliefs which replicates these patterns. The model is embedded within a non-expected utility model of life-cycle consumption and saving. Our analysis shows that agents with ambiguous survival beliefs (i) save less than originally planned, (ii) exhibit undersaving at younger ages, and (iii) hold longer on to their assets than their rational expectations counterparts who correctly assess survival probabilities. Our ambiguity-driven model therefore simultaneously accounts for three important empirical findings on household saving behavior. |
| JEL: | D91 D83 E21 |
| Date: | 2013–05–15 |
| URL: | http://d.repec.org/n?u=RePEc:kls:series:0063&r=hea |
| By: | Denise Hoffman; Kristin Andrews; Valerie Cheh |
| Keywords: | Medicaid Buy-In, High Earners, Service Use, Health, Disability |
| JEL: | I J I |
| Date: | 2013–05–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7793&r=hea |
| By: | Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Newuman |
| Keywords: | Medicare Advantage, Enrollment, Affordable Care Act, Health |
| JEL: | I |
| Date: | 2013–06–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7794&r=hea |
| By: | Young Kyung Do; Edward C. Norton; Sally Stearns; Courtney H. Van Houtven |
| Abstract: | This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters-in-law are the prevalent source of caregivers for frail elderly parents and parents-in-law. A key insight of our instrumental variable approach is that having a parent-in-law with functional limitations increases the probability of providing informal care to that parent-in-law, but a parent-in-law's functional limitation does not directly affect the daughter-in-law's health. We compare results for the daughter-in-law and daughter samples to check the assumption of the excludability of the instruments for the daughter sample. Our results show that providing informal care has significant adverse effects along multiple dimensions of health for daughter-in-law and daughter caregivers in South Korea. |
| JEL: | I1 |
| Date: | 2013–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19142&r=hea |
| By: | Michael Grossman; Erdal Tekin; Roy Wada |
| Abstract: | In this paper, we examine the effect of food prices on clinical measures of obesity, including body mass index (BMI) and percentage body fat (PBF) measures derived from bioelectrical impedance analysis (BIA) and dual energy x-ray absorptiometry (DXA), among youths ages 12 through 18. The empirical analyses employ data from various waves of the National Health and Nutrition Examination Survey (NHANES) merged with several food prices measured by county and year. This is the first study to consider clinically measured levels of body composition rather than BMI to investigate the effects of food prices on obesity among youths. We also examine whether the effects of food prices on body composition differ by gender and race/ethnicity. Our findings suggest that increases in the real price of one calorie in food for home consumption and the real price of fast-food restaurant food lead to improvements in obesity outcomes among youths. We also find that an increase in the real price of fruits and vegetables has negative consequences for these outcomes. Finally, our results indicate that measures of PBF derived from BIA and DXA are no less sensitive and in some cases more sensitive to the prices just mentioned than BMI. |
| JEL: | I1 I18 |
| Date: | 2013–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19143&r=hea |
| By: | Mariacristina De Nardi; Eric French; John Bailey Jones |
| Abstract: | The old age provisions of the Medicaid program were designed to insure poor retirees against medical expenses. However, it is the rich who are most likely to live long and face expensive medical conditions when very old. We estimate a rich structural model of savings and endogenous medical spending with heterogeneous agents, and use it to compute the distribution of lifetime Medicaid transfers and Medicaid valuations across single retirees. We find that retirees with high lifetime incomes can end up on Medicaid, and often value Medicaid’s insurance features the most, as they face a larger risk of catastrophic medical needs at old ages, and face the greatest consumption risk. Finally, our compensating differential calculations indicate that retirees value Medicaid insurance at more than its actuarial cost, but that most would value expansions of the current Medicaid program at less than cost. |
| JEL: | D11 D14 D31 E21 H2 I14 |
| Date: | 2013–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19151&r=hea |
| By: | Andersson, Henrik |
| JEL: | D61 J17 R41 |
| Date: | 2013–07 |
| URL: | http://d.repec.org/n?u=RePEc:ner:toulou:http://neeo.univ-tlse1.fr/3478/&r=hea |
| By: | Denise Doiron (School of Economics, the University of New South Wales); Denzil G Fiebig (School of Economics, the University of New South Wales); Agne Suziedelyte (School of Economics, the University of New South Wales) |
| Abstract: | The separate identification of effects due to incentives, selection and preference heterogeneity in insurance markets is the topic of much debate. In this paper, we investigate the presence and variation in moral hazard across health care procedures. The key motivating hypothesis is the expectation of larger causal effects in the case of more discretionary procedures. The empirical approach relies on an extremely rich and extensive dataset constructed by linking survey data to administrative data for hospital medical records. Using this approach we are able to provide credible evidence of large moral hazard effects but for elective surgeries only. |
| Keywords: | health insurance, asymmetric information, moral hazard |
| JEL: | D82 I11 |
| Date: | 2013–06 |
| URL: | http://d.repec.org/n?u=RePEc:swe:wpaper:2013-14&r=hea |