nep-hea New Economics Papers
on Health Economics
Issue of 2018‒06‒25
28 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Take-Up, Drop-Out, and Spending in ACA Marketplaces By Rebecca Diamond; Michael J. Dickstein; Timothy McQuade; Petra Persson
  2. Extrapolation using Selection and Moral Hazard Heterogeneity from within the Oregon Health Insurance Experiment By Amanda E. Kowalski
  3. Contemporaneous and Long-Term Effects of Children's Public Health Insurance Expansions on Supplemental Security Income Participation By Michael Levere; Sean Orzol; Lindsey Leininger; Nancy Early
  4. Benefit Duration and Return to Work Outcomes in Short Term Disability Insurance Programs: Evidence from Temporary Disability Insurance Program By Annette M. Bourbonniere; David R. Mann
  5. The Impact of Sickness Absenteeism on Productivity: New Evidence from Belgian Matched Panel Data By Grinza, Elena; Rycx, Francois
  6. The Minimum Wage, Fringe Benefits, and Worker Welfare By Jeffrey Clemens; Lisa B. Kahn; Jonathan Meer
  7. Unemployment and social exclusion By Pohlan, Laura
  8. Do 'All-Age' Bicycle Helmet Laws Work? Evidence from Canada By Christopher S. Carpenter; Casey Warman
  9. Habit formation, obesity, and cash rewards By Augurzky, Boris; Bauer, Thomas K.; Reichert, Arndt R.; Schmidt, Christoph M.; Tauchmann, Harald
  10. Public acceptability of financial incentives to reward pregnant smokers who quit smoking: a United Kingdom–France comparison By Noémi Berlin; Léontine Goldzahl; Linda Bauld; Pat Hoddinott; Ivan Berlin
  12. Environmental Bottlenecks on Children's Genetic Potential for Adult Socioeconomic Attainments: Evidence from a Health Shock By Fletcher, Jason M.
  13. Male Reproductive Health, Fairness and Optimal Policies By Johanna Etner; Natacha Raffin; Thomas Seegmuller
  14. Long-run Effects of Lottery Wealth on Psychological Well-being By Lindqvist, Erik; Östling, Robert; Cecarini, David
  15. Why People Hate Health Economics – Two Psychological Explanations By Tinghög, Gustav; Västfjäll, Daniel
  16. Domain-Specific Risk and Public Policy By Kanninen, Ohto; Böckerman, Petri; Suoniemi, Ilpo
  17. Labor Force Participation of the Elderly in Japan By Takashi Oshio; Emiko Usui; Satoshi Shimizutani
  18. Trends in Labor Force Participation of Older Workers in Spain By Pilar García-Gómez; Sergi Jimenez-Martin; Judit Vall Castelló
  19. Are rising house prices really good for your brain? House value and cognitive functioning among older Europeans By Isabelle CHORT; Bénédicte APOUEY
  20. Labor Market and Distributional Effects of an Increase in the Retirement Age By Geyer, Johannes; Haan, Peter; Hammerschmid, Anna; Peters, Michael
  21. Why are People Working Longer in the Netherlands? By Adriaan Kalwij; Arie Kapteyn; Klaas de Vos
  22. The Shadow Prices of Voluntary Caregiving: Using Panel Data of Well-Being to Estimate the Cost of Informal Care By McDonald, Rebecca; Powdthavee, Nattavudh
  23. What are the impacts of living in social housing? By David Prentice; Rosanna Scutella
  24. Pollution and Growth: The Role of Pension on the Efficiency of Health and Environmental Policies By Armel Ngami; Thomas Seegmuller
  25. Impact of the Clean Air Act on Air Pollution and Infant Health: Evidence from South Korea By Lee, Soohyung; Yoo, Heesun; Nam, Minhyuk
  26. Pollution, green union and network industry By Fanti, Luciano; Buccella, Domenico
  27. Technical efficiency of Slovak general hospitals By Richard Kališ
  28. Cumulative Impacts of Conditional Cash Transfer Programs: Experimental Evidence from Indonesia By Nur Cahyadi; Rema Hanna; Benjamin A. Olken; Rizal Adi Prima; Elan Satriawan; Ekki Syamsulhakim

  1. By: Rebecca Diamond; Michael J. Dickstein; Timothy McQuade; Petra Persson
    Abstract: The Affordable Care Act (ACA) established health insurance marketplaces where consumers can buy individual coverage. Leveraging novel credit card and bank account micro-data, we identify new enrollees in the California marketplace and measure their health spending and premium payments. Following enrollment, we observe dramatic spikes in individuals' health care consumption. We also document widespread attrition, with more than half of all new enrollees dropping coverage before the end of the plan year. Enrollees who drop out re-time health spending to the months of insurance coverage. This drop-out behavior generates a new type of adverse selection: insurers face high costs relative to the premiums collected when they enroll strategic consumers. We show that the pattern of attrition undermines market stability and can drive insurers to exit, even absent differences in enrollees' underlying health risks. Further, using data on plan price increases, we show that insurers largely shift the costs of attrition to non-drop-out enrollees, whose inertia generates low price sensitivity. Our results suggest that campaigns to improve use of social insurance may be more efficient when they jointly target take-up and attrition.
    JEL: H4 H51 I13 L1
    Date: 2018–05
  2. By: Amanda E. Kowalski
    Abstract: I aim to shed light on why emergency room (ER) utilization increased following the Oregon Health Insurance Experiment but decreased following a Massachusetts policy. To do so, I unite the literatures on insurance and treatment effects. Under an MTE model that assumes no more than the LATE assumptions, comparisons across always takers, compliers, and never takers can inform the impact of polices that expand and contract coverage. Starting from the Oregon experiment as the "gold standard," I make comparisons within Oregon and extrapolate my findings to Massachusetts. Within Oregon, I find adverse selection and heterogeneous moral hazard. Although previous enrollees increased their ER utilization, evidence suggests that subsequent enrollees will be healthier, and they will decrease their ER utilization. Accordingly, I can reconcile the Oregon and Massachusetts results because the Massachusetts policy expanded coverage from a higher baseline, and new enrollees reported better health.
    JEL: C1 H75 I10 I13
    Date: 2018–05
  3. By: Michael Levere; Sean Orzol; Lindsey Leininger; Nancy Early
    Abstract: We assess how increased Medicaid generosity affects participation in SSI. In states where SSI recipients did not automatically receive Medicaid, expansions in public health insurance coverage significantly decreased applications and awards. In the long-term, increased Medicaid eligibility during childhood reduced young adult SSI applications.
    Keywords: SSI, CHIP, health insurance, substitution
    JEL: I J
  4. By: Annette M. Bourbonniere; David R. Mann
    Abstract: Findings suggest that STDI claimants with certain characteristics are more likely to receive benefits for a long duration or not receive PRTW benefits, signaling that they might benefit from early Vocational Rehabilitation supports and services that would allow them to remain productive members of the workforce and avoid long term benefit receipt.
    Keywords: State temporary disability insurance , Return-to-work , Early intervention
    JEL: I J
  5. By: Grinza, Elena (University of Milan); Rycx, Francois (Free University of Brussels)
    Abstract: We investigate the impact of sickness absenteeism on productivity by using rich longitudinal matched employer-employee data on Belgian private firms. We deal with endogeneity, which arises from unobserved firm heterogeneity and reverse causality, by applying a modified version of the Ackerberg et al's (2015) control function method, which explicitly removes firm fixed effects. Our main finding is that, in general, sickness absenteeism substantially dampens firm productivity. An increase of 1 percentage point in the rate of sickness absenteeism entails a productivity loss of 0.24%. Yet, we find that the impact is much diversified depending on the categories of workers who are absent and across different types of firms. Our results show that sickness absenteeism is detrimental mainly when absent workers are high-tenure or blue-collar workers. Moreover, they show that sickness absenteeism is harmful mostly to industrial firms, high capital-intensive companies, and small- and medium-sized enterprises. This overall picture is coherent with the idea that sickness absenteeism is problematic when absent workers embed high levels of firm/task-specific (tacit) knowledge, when the work of absent employees is highly interconnected with the work of other employees (e.g., along the assembly line), and when firms face more limitations in substituting temporarily absent workers.
    Keywords: sickness absenteeism, firm productivity, semiparametric methods for estimating production functions, longitudinal matched employer-employee data
    JEL: D24 M59 I15
    Date: 2018–05
  6. By: Jeffrey Clemens; Lisa B. Kahn; Jonathan Meer
    Abstract: This paper explores the relationship between the minimum wage, the structure of employee compensation, and worker welfare. We advance a conceptual framework that describes the conditions under which a minimum wage increase will alter the provision of fringe benefits, alter employment outcomes, and either increase or decrease worker welfare. Using American Community Survey data from 2011-2016, we find robust evidence that state-level minimum wage changes decreased the likelihood that individuals report having employer-sponsored health insurance. Effects are largest among workers in very low-paying occupations, for whom coverage declines offset 9 percent of the wage gains associated with minimum wage hikes. We find evidence that both insurance coverage and wage effects exhibit spillovers into occupations moderately higher up the wage distribution. For these groups, reductions in coverage offset a more substantial share of the wage gains we estimate.
    JEL: I13 J23 J32 J33
    Date: 2018–05
  7. By: Pohlan, Laura
    Abstract: This paper analyzes the economic and social consequences of job loss which contribute to exclusion from society based on German linked survey and administrative data. To study the causal relationship between unemployment and multiple dimensions of social marginalization, I combine inverse propensity score weighting with a difference-in-differences approach. The results suggest that job loss has particularly detrimental effects on the subjective perception of social integration, life satisfaction, the access to economic resources and mental health. Moreover, this paper shows that becoming unemployed hinders the fulfillment of psychosocial needs that are typically associated with working, such as social status and higher self-efficacy. The effects of job loss are long-lasting, growing more profound the longer the duration of unemployment and persisting following reemployment. Looking at effect heterogeneity, I find that having a partner and being highly educated reduces the negative effects of job loss.
    Keywords: job loss,unemployment,social exclusion,inverse probability weighting
    JEL: I31 J64
    Date: 2018
  8. By: Christopher S. Carpenter; Casey Warman
    Abstract: Twenty-one states and the District of Columbia require youths to wear helmets when riding a bicycle, and there has been a push to extend such laws to adults. We provide new evidence on helmet laws by studying Canada using difference-in-differences models and restricted area-identified public health survey data with information on cycling and helmet use for nearly 800,000 individuals from 1994-2014. We first confirm prior patterns from the US that laws requiring youths to wear helmets significantly increased youth helmet use. We then provide the literature’s first comprehensive evidence that ‘all-age’ bicycle helmet laws significantly increased both adult and youth helmet use by 50 to 190 percent relative to pre-reform levels, with larger effects for younger adults, and less-educated adults. All-age helmet laws had modest effects at reducing cycling and increasing in-home exercise during winter months among adults but did not meaningfully affect weight. Finally, we find larger effects of helmet laws at increasing helmet use for adults with children in the household, consistent with role-modeling behavior. Overall our findings confirm that all-age helmet laws can be effective at increasing population helmet use without significant unintended adverse health consequences.
    JEL: I1 I12 I18 Z18
    Date: 2018–05
  9. By: Augurzky, Boris; Bauer, Thomas K.; Reichert, Arndt R.; Schmidt, Christoph M.; Tauchmann, Harald
    Abstract: This paper examines weight loss and the formation of healthy habits through cash rewards in the context of a multi-phase randomized controlled trial involving 700 obese individuals. We find effects of monetary incentives for weight loss of up to EUR 300 on body weight during all experimental phases, including a period of a year and a half following the exposure to the financial rewards. We also find effects on healthy behavior during this follow-up phase. After the initial incentive period, we additionally provided participants who had lost a substantial amount of weight with monetary rewards of up to EUR 500. These had only short-term effects on body weight and healthy behavior. We argue that our findings are best explained by monetarily incentivized participants having formed healthy habits by the time the experiment ended and that only the speed of the transition to the new (health) equilibrium was affected by the additional rewards. Contrary to the pessimistic perspective presented in earlier empirical research on habit formation, our results suggest that a simple program relying on weight loss rewards can result in long-term health behavioral change.
    Keywords: field experiment,obesity,healthy behavior,habit formation,sustainability,monetary incentives
    JEL: I12 I18 D03 C93
    Date: 2018
  10. By: Noémi Berlin (EUI - European University Institute - European University Institute (Florence, IT)); Léontine Goldzahl (Université Paris-Dauphine); Linda Bauld (University of Stirling); Pat Hoddinott (University of Stirling); Ivan Berlin (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - UP11 - Université Paris-Sud - Paris 11 - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale)
    Abstract: A substantial amount of research has been conducted on financial incentives to increase abstinence from smoking among pregnant smokers. If demonstrated to be effective, financial incentives could be proposed as part of health care interventions to help pregnant smokers quit. Public acceptability is important; as such interventions could be publicly funded. Concerns remain about the acceptability of these interventions in the general population. We aimed to assess the acceptability of financial incentives to reward pregnant smokers who stop smoking using a survey conducted in the UK and then subsequently in France, two developed countries with different cultural and social backgrounds. More French than British respondents agreed with financial incentives for rewarding quitting smoking during pregnancy, not smoking after delivery, keeping a smoke-free household, health service payment for meeting target and the maximum amount of the reward. However, fully adjusted models showed significant differences only for the two latter items. More British than French respondents were neutral toward financial incentives. Differences between the representative samples of French and British individuals demonstrate that implementation of financial incentive policies may not be transferable from one country to another.
    Date: 2018
  11. By: Raffaella Barone; Domenico Delle Side; Donato Masciandaro
    Abstract: The aim of the paper is to analyze theoretically and empirically the impact the macroeconomic cycle has on the accumulation of capital by organized crime, using estimates for the global drug market. So far the economic literature has neglected the relationships existing between illegal markets, money laundering, and the business cycle. We propose a dynamic model where the business cycle influences the criminal economy via two different channels. On the one side, illegal markets grow at variable rates, depending on the health of the legal economy. Secondly, a pass-through effect can exist, since the business cycle affects the legal markets which criminal operators use to launder their revenues. Furthermore, we analyze the consequences of a “saturation effect” limiting maximum accumulation of illegal capital. We find that overall illegal capital is affected by the business cycle through a capital multiplier; in addition to this, the dynamics of interest rates in financial markets can influence such multiplier.
    Date: 2017
  12. By: Fletcher, Jason M. (University of Wisconsin-Madison)
    Abstract: This paper explores gene-environmental interactions between family environments and children's genetic scores in determining educational attainment. The central question is whether poor childhood family environments reduce the ability for children to leverage their genetic gifts to achieve high levels of educational attainments. The multigenerational information and genetic data contained in the Health and Retirement Study is used to separate two mechanisms of intergenerational transmission of socioeconomic status – genetic endowments and family environments. Using parental in utero exposure to the 1918/1919 influenza pandemic as a source of quasi-experimental variation to family environments (but not affecting children's genetic endowments), this paper estimates interactions between parental investments and children's genetic potential. The main finding suggests that girls with high genetic potential whose fathers were exposed to influenza face reduced educational attainments – a gene-environment interaction – but there is no similar effect for boys.
    Keywords: in utero exposure, gene-environment interactions, polygenic score, intergenerational effects
    JEL: J62 J1 J24
    Date: 2018–05
  13. By: Johanna Etner (EconomiX, UPL, Univ Paris Nanterre, CNRS); Natacha Raffin (Université Rouen Normandie, CREAM and EconomiX, UPL, Univ Paris Nanterre, CNRS); Thomas Seegmuller (Aix-Marseille Univ., CNRS, EHESS, Centrale Marseille, AMSE)
    Abstract: Based on epidemiological evidence, we consider an economy where agents differ through their ability to procreate. Households with impaired fertility may incur health expenditures to increase their chances of parenthood. This health heterogeneity generates welfare inequalities that deserve to be ruled out. We explore three different criteria of social evaluation in the long-run: the utilitarian approach, which considers the well- being of all households, the ex-ante egalitarian criterion, which considers the expected well-being of the worst-off social group, and the ex-post egalitarian one, which only considers the realized well-being of the worst- off. In an overlapping generations model, we propose a set of economic instruments to decentralize each solution. To correct for the externality and inequalities, both a preventive (a taxation of capital) and a redistributive policy are required.
    Keywords: reproductive health, fairness, egalitarianism, optimal policy, OLG model
    JEL: I18 I31 H23 D63
    Date: 2018–05
  14. By: Lindqvist, Erik (Department of Economics); Östling, Robert (Institute for International Economic Studies); Cecarini, David (Department of Economics)
    Abstract: We surveyed a large sample of Swedish lottery players about their psychological well-being and analyzed the data following pre-registered procedures. Relative to matched controls, large-prize winners experience sustained increases in overall life satisfaction that persist for over a decade and show no evidence of dissipating with time. The estimated treatment effects on happiness and mental health are significantly smaller, suggesting that wealth has greater long-run effects on evaluative measures of well-being than on affective ones. Follow-up analyses of domain-specific aspects of life satisfaction clearly implicate financial life satisfaction as an important mediator for the long-run increase in overall life satisfaction.
    Keywords: Psychological Well-being; Subjective Well-being; Happiness
    JEL: D69 I31
    Date: 2018–06–18
  15. By: Tinghög, Gustav (Division of Economics, Department of Management and Engineering, Linköping University); Västfjäll, Daniel (Division of Economics, Department of Management and Engineering, Linköping University)
    Abstract: We will argue that health economics at large has been oblivious to the core aspects of human nature outlined in this paper, and this has limited the use of health economics as a productive input in health policy.
    Keywords: Health Economics; Medical Decision Making; Health Care Priority Setting; Emotions; Psychology
    JEL: I19
    Date: 2018–06–20
  16. By: Kanninen, Ohto (Labour Institute for Economic Research); Böckerman, Petri (Labour Institute for Economic Research); Suoniemi, Ilpo (Labour Institute for Economic Research)
    Abstract: We develop a method to estimate domain-specific risk. We apply the method to sickness insurance by fitting a utility function at the individual level, using European survey data on life satisfaction. Three results stand out. First, relative risk aversion increases with income. Second, marginal utility is higher in the sick state conditional on income, due to an observed fixed cost of sickness. Third, the domain-specificity of risk shifts the focus on the smoothing of utility, not consumption. The optimal policy rule implies that the replacement rates should be non-linear and decrease with income.
    Keywords: risk, risk aversion, state-dependence, social insurance, sickness absence
    JEL: D02 H55 I13
    Date: 2018–05
  17. By: Takashi Oshio; Emiko Usui; Satoshi Shimizutani
    Abstract: Japan experienced increases in labor force participation (LFP) of the elderly in recent years, as have other advanced countries. In the present study, we overview the employment trend of the elderly in Japan, and examine what factors have contributed to its increase since the early 2000s. Improved health and longevity, increasing education levels, and a shift towards less physically demanding jobs have allowed the elderly to stay longer in the labor force. However, elderly employment rebound and its timing are more closely linked to changes in social security incentives, especially increases in the eligibility age for public pension benefits. More broadly, reduced generosity in social security programs since the mid-1980s has been a key driver of the long-term trend change in elderly employment. A series of social security reforms have helped utilize the elderly’s potential work capacity, accumulated due to improving health conditions and other favorable factors for LFP in the elderly.
    JEL: H55 J21 J26
    Date: 2018–05
  18. By: Pilar García-Gómez; Sergi Jimenez-Martin; Judit Vall Castelló
    Abstract: Similar to other OECD countries, labor force participation rates of Spanish older workers were falling until the mid-1990s when there was a reversal in the trend. Labor force participation rates of Spanish men have been increasing since then, although at a slower pace than in other OECD countries. We explore to what extent several factors can be behind these trends. First, we conclude that the (old-age) social security system (except perhaps for the disability component) has played a marginal (at most) role on this reversal given the lack of major changes in social security benefits until the last set of reforms in 2011 and 2013. Second, we also rule out that changes in the health status of the population are responsible for the reversal of this trend. Finally, we find that aggregate economic conditions, and differences across cohorts in both the skill composition and the labor force attachment of wives are potential drivers of these observed changes.
    JEL: J14 J21 J26
    Date: 2018–05
  19. By: Isabelle CHORT; Bénédicte APOUEY
    Abstract: This study examines how house prices in fluence cognitive functioning for individuals aged 50+ in Europe. Using data from the Survey of Health, Ageing and Retirement (SHARE) between 2004 and 2015, we compute the median house price for each region-year, using individual self-reported house values. Cognitive scores capture either fl uid intelligence (numeracy, memory) or a mix of fl uid and crystallized intelligences (verbal fluency). Compared with the previous literature, we allow housing market fl uctuations to have different effects during episodes of price increases and decreases, and we study owners with a mortgage, owners without a mortgage, and tenants separately. Findings indicate that house price booms do not systematically improve cognitive health outcomes: for outright owners and tenants, a rise in prices correlates with a decrease in fluid intelligence. For outright owners, this result is partly explained by increased alcohol consumption, and is also related to stronger feelings of guilt and irritability, consistent with aversion to advantageous inequality. Findings also show asymmetry in the effects of price booms and busts: indeed, for mortgaged owners, both price increase and decrease episodes have a positive impact on cognitive outcomes. We argue that during the crisis the beneficial impact of price busts may have been driven by the decline in interest rates, which reduced the debt burden of households with a variable rate mortgage.
    Keywords: House prices, Wealth, Cognitive functioning, Health, Older Europeans, Europe, SHARE
    JEL: D12 I1 I3 J14
    Date: 2018–06
  20. By: Geyer, Johannes (DIW); Haan, Peter (DIW); Hammerschmid, Anna (DIW); Peters, Michael (DIW)
    Abstract: We evaluate the labor market and distributional effects of an increase in the early retirement age (ERA) from 60 to 63 for women. We use a regression discontinuity design which exploits the immediate increase in the ERA between women born in 1951 and 1952. The analysis is based on the German micro census which includes about 370,000 households per year. We focus on heterogeneous labor market effects on the individual and on the household level and we study the distributional implications using net household income. In this respect we extend the previous literature which mainly studied employment effects on the individual level. Our results show sizable labor market effects which strongly differ by subgroups. We document larger employment effects for women who cannot rely on other income on the household level, e.g. women with a low income partner. The distributional analysis shows on average no significant effects on female or household income. This result holds as well for heterogeneous groups: Even for the most vulnerable groups, such as single women, women without higher education, or low partner income, we do not find significant reductions in income. One reason for this result is program substitution.
    Keywords: retirement age; pension reform; labor supply; early retirement; distributional effects; spillover effects; household;
    JEL: J14 J18 J22 J26 H31
    Date: 2018–06–18
  21. By: Adriaan Kalwij; Arie Kapteyn; Klaas de Vos
    Abstract: Labor force participation at older ages has been rising in the Netherlands since the mid-nineteen-nineties. Reforms of the social security and pension systems have often been put forward as main explanations for this rise. However, participation rates above the normal retirement age of 65 have almost tripled for men and quadrupled for women despite the fact that at those ages reforms are unlikely to have had much impact. This suggests other factors may have played an important role in this rise as well. In addition to the effects of reforms in social security and pension systems, this chapter examines the importance for men’s labor force participation at older ages of improved health, increased levels of education, and differences in skills across cohorts, as the older cohorts moved into retirement, such that workers’ characteristics better matched labor demand. These changes on the labor supply side are likely to have contributed to the success of the reforms since the mid-nineteen-nineties and to have had a large independent impact on men’s labor force participation at older ages.
    JEL: J14 J18 J26
    Date: 2018–05
  22. By: McDonald, Rebecca (University of Birmingham); Powdthavee, Nattavudh (University of Warwick)
    Abstract: This paper uses the wellbeing valuation (WV) approach to estimate and monetize the wellbeing impacts of informal care provision on caregivers. Using nationally representative longitudinal data from the U.K., we address two challenging methodological issues related to the economic valuation of informal care: (i) the endogeneity of informal care; and (ii) the sensitivity of income estimates used in valuation. We address the endogeneity issue by decomposing wellbeing losses into those associated with caring for a relative who had recently suffered a serious accident and those associated with caring for a relative who had not had an accident. We use of the Fixed Effects Filtered (FEF) estimator to enable the permanent income coefficient to be estimated free from individual fixed effects bias. This estimate is used instead of the transient income effect in the calculation of shadow prices of informal care. Our estimates suggest that permanent income would have to increase by approximately £102k per year on average to just compensate for the wellbeing losses from providing informal care.
    Keywords: informal care, well-being, compensation variations, permanent income, happiness, shadow prices
    JEL: H8 I18 I31
    Date: 2018–05
  23. By: David Prentice (Infrastructure Victoria); Rosanna Scutella (RMIT)
    Abstract: In this paper we take the first steps to providing parameters for use in the cost benefit analysis of investments in social housing by estimating its effects on outcomes for individual residents. This is done by applying statistical matching methods to the Journeys Home dataset to provide new estimates of the impacts of social housing on employment, education, health, incarceration and homelessness. We find placing an individual, vulnerable to becoming homeless, in social housing means they are less likely, compared with other similar individuals not in social housing, to become homeless. Hence, social housing is providing an important `safety net’ for people vulnerable to homelessness. We also find that in the short run individuals in social housing have similar outcomes in terms of employment, education, physical and mental health, and incarceration to similarly disadvantaged individuals not in social housing. These results are potentially due to strict targeting of individuals into relatively limited available spots in social housing and the averaging across cohort specific effects. The long run impacts, for some cohorts, may differ but analysing this requires longer datasets. Creation Date: 2018-05-16
    Keywords: Social Housing, Matching Methods, Homelessness, Employment, Education, Health, Incarceration
    JEL: C21 D61 I38 H42 H54
  24. By: Armel Ngami (Aix-Marseille Univ., CNRS, EHESS, Centrale Marseille, AMSE); Thomas Seegmuller (Aix-Marseille Univ., CNRS, EHESS, Centrale Marseille, AMSE)
    Abstract: This paper analyses the effect of a pay-as-you-go pension system on the evolution of capital and pollution, and on the efficiency of an environmental versus health policy. In an overlapping generations model (OLG), we introduce endogenous longevity that depends on pollution and health expenditures. Global dynamics may display multiple balanced growth paths (BGP). We show that by discouraging savings, a policy that promotes the pension system enlarges the environmental poverty trap. More surprisingly, the environmental policy has contrasted effects according to the significance of the pension system. If it has a low size, a raise of the environmental policy enlarges the environmental poverty trap and leads to a rise in capital over pollution at the highest stationary equilibrium. In contrast, in economies where intergenerational solidarity is well developed, capital over pollution decreases at the highest BGP. In such a case, the environmental policy does not necessarily lead to a better longevity and growth.
    Keywords: longevity, environment, Health, pension system, growth, Pollution
    Date: 2018–05
  25. By: Lee, Soohyung (Sogang University); Yoo, Heesun (Vanderbilt University); Nam, Minhyuk (Sogang University)
    Abstract: This paper examines the extent to which the 2005 Clean Air Act introduced in South Korea affected air pollution and infant health. To identify the causal effect, we exploit the time and geographical variations in the adoption of the Act between 2003 and 2006. During this period, the Clean Air Act indeed significantly reduced air pollutants. For example, the PM10 level was reduced by 9 percent. However, the Act's impact on infant mortality was not statistically significant.
    Keywords: air pollution, infant mortality, PM10
    JEL: I18 K32 Q52
    Date: 2018–05
  26. By: Fanti, Luciano; Buccella, Domenico
    Abstract: In this paper the authors investigate whether and how, in a network industry, the intensity of network effects affect the total pollution under the presence of a union interested to "local" environmental damages (e.g. polluting production processes damaging workers' health and the local environment where workers live). Under monopoly, it is shown that network effects tend to increase, on the one hand, the investments in the cleaning technology but, on the other hand, the polluting output, so that their effects on the total pollution are theoretically ambiguous. In particular, the authors find that total pollution is reduced (resp. increased) with increasing network effects intensity if the market is sufficiently large (resp. small). Moreover the pollution-reducing result of the increasing network effect is more likely when the existing network effects, the union's environmental concerns and the technological efficiency are sufficiently large. These findings are qualitatively confirmed also under different union's preferences, Government's environmental standard and Cournot duopoly, and thus offer interesting empirical as well as policy implications.
    Keywords: network goods,cleaning technology,pollution production,green unions,monopoly,Cournot duopoly
    JEL: J51 L12
    Date: 2018
  27. By: Richard Kališ (University of Economics Bratislava)
    Abstract: In this study, technical efficiency of Slovak general hospitals was investigated. The well-known non-parametric Data Envelopment Analysis was used to compare performance of Slovak health care providers. Results are based on four slightly differentiated models. Both CRS and VRS variation with different input approaches were used. Our results suggest low average efficiency in Slovak hospitals in the range 0.45 to 0.62 with great variations in efficiency score between individual Decision Making Units (DMUs). These results are relative without appropriate cross-country comparisons. Furthermore, in type of hospital entity there is no significant difference in efficiency score. However there is not a single efficient DMU in a group of municipality hospitals. Although, these results must be taken with caution due to questionable quality of data, this paper provides some valuable overview on technical efficiency of health care providers
    Keywords: data envelopment analysis; hospitals; efficiency
    JEL: P41 G34 C44
    Date: 2018–10–06
  28. By: Nur Cahyadi; Rema Hanna; Benjamin A. Olken; Rizal Adi Prima; Elan Satriawan; Ekki Syamsulhakim
    Abstract: Conditional cash transfer (CCT) programs have spread worldwide, and are designed to promote comprehensive human capital investments in children, starting from encouraging pre-natal and maternal care and early childhood health interventions and continuing through incentivizing school attendance. Yet evaluating these claims over more than a few years is hard, as most CCT experiments extend the program to the control group after a short experimental period. This paper experimentally estimates the impacts of Indonesia’s cash transfer program (PKH) six years after the program launched, using data from about 14,000 households in 360 sub-districts across Indonesia, taking advantage of the fact that treatment and control locations remained largely intact throughout the period. We find that PKH continues to have large static incentive effects on many of the targeted indicators, increasing usage of trained health professionals for childbirth dramatically and halving the share of children age 7-15 who are not enrolled in school. Wage labor for 13-15 year olds was reduced by at least one-third. We also begin to observe impacts on outcomes that may require cumulative investments: for example, six years later, we observe large reductions in stunting and some evidence of increased high school completion rates. The results suggest that CCT investments can have substantial effects on the accumulation of human capital, and that these effects can persist even when programs are operating at large-scale without researcher intervention.
    JEL: I38 O10
    Date: 2018–05

This nep-hea issue is ©2018 by Nicolas R. Ziebarth. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.