nep-hea New Economics Papers
on Health Economics
Issue of 2019‒04‒29
seven papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. In sickness and in health? Health shocks and relationship breakdown: Empirical evidence from Germany By Bünnings, Christian; Hafner, Lucas; Reif, Simon; Tauchmann, Harald
  2. The Influence of Old-age Retirement on Health: Causal Evidence from the Finnish Register Data By Kuusi, Tero; Martikainen, Pekka; Valkonen, Tarmo
  3. Does facilitated access to the health system improve asylum-seekers' health outcomes? : Evidence from a quasi-experiment By Jaschke, Philipp; Kosyakova, Yuliya
  4. Product patents and access to innovative medicines in a post-trips-era By Watal, Jayashree; Dai, Rong
  5. Risk-Mitigating Technologies: the Case of Radiation Diagnostic Devices By Galasso, Alberto; Luo, Hong
  6. An Unconventional Way to Support Health Expenditure By Nizam, Ahmed Mehedi
  7. Positive Early Life Rainfall Shocks and Adult Mental Health By Mochamad Pasha; Marc Rockmore; Chih Ming Tan

  1. By: Bünnings, Christian; Hafner, Lucas; Reif, Simon; Tauchmann, Harald
    Abstract: From an economic perspective, marriage and long-term partnership can be seen as a riskpooling device. This informal insurance contract is, however, not fully enforceable. Each partner is free to leave when his or her support is needed in case of an adverse life event. An adverse health shock is a prominent example for such events. Since relationship breakdown itself is an extremely stressful experience, partnership may backfire as informal insurance against health risks, if health shocks increase the likelihood of relationship breakdown. We address this question empirically, using survey data from Germany. Results from various matching estimators indicate that adverse shocks to mental health substantially increase the probability of a couple splitting up over the following two years. In contrast, there is little effect of a sharp decrease in physical health on relationship stability. If at all, physical health shocks that hit both partners simultaneously stabilize a relationship.
    Keywords: separation,partnership dissolution,health shock,MCS,PCS,matching
    JEL: I12 J12 D13
    Date: 2019
  2. By: Kuusi, Tero; Martikainen, Pekka; Valkonen, Tarmo
    Abstract: Abstract We quantify the impact of old-age retirement on health using longitudinal Finnish register data for the period 2000–2012, which allows for a strict isolation of the effects of transition from work to retirement for both mental and physical health indicators. We use the lowest statutory eligibility age for full old-age pensions, 63 years, as an instrument in FE-IV estimation to ensure causal inference. We find that (1) retirement moderately decreases the use of antidepressants, especially for women; (2) the beneficial effects of retirement on the cardiovascular and musculoskeletal conditions are smaller and more diffused; (3) there is no robust evidence that retirement effects vary systematically among socioeconomic groups, although more robust declines in musculoskeletal diseases were observed among manual-labour men; and (4) the beneficial effects in antidepressant use can be extended to apply to most Finns retiring at ages 62–64 based on our test of external validity.
    Keywords: Health, Health behaviour, Retirement, Retirement policies, Demographic economics
    JEL: I10 I12 J26 J18
    Date: 2019–04–18
  3. By: Jaschke, Philipp (Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany]); Kosyakova, Yuliya (Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany])
    Abstract: "As long as their asylum application is not approved or their duration of stay does not exceed 15 months, asylum-seekers who require doctor visit have to claim it either by the local authority for foreigners or the responsible social assistance office in Germany. Since 2016 several Federal states and municipalities in Germany have launched the procedure to hand out electronic health cards (eHC) which allow immediate direct access to the health system for asylum-seekers. In this paper, we examine whether being eligible to the eHC as a result of the policy change has had an effect on the health outcomes of asylum-seekers in Germany. For empirical identification, we take advantage of the variation of the policy change across regions and over time. Relying on data from the IAB-BAMF-SOEP Survey of Refugees, we find that the introduction of the reforms allowing asylum-seekers' faster and more direct access to the healthcare system indeed reduced the risk of emotional disorder. We conclude by discussing the potential pros and contras of a comprehensive nationwide introduction of the eHC for asylum-seekers." (Author's abstract, IAB-Doku) ((en))
    Date: 2019–04–10
  4. By: Watal, Jayashree; Dai, Rong
    Abstract: This WTO working paper studies availability and affordability of new and innovative pharmaceuticals in a post-TRIPS era. The WTO's TRIPS Agreement (TRIPS) makes it obligatory for WTO members − except least-developed country members (LDCs) - to provide pharmaceutical product patents with a 20-year protection term. Developing country members, other than LDCs, were meant to be compliant with this provision of TRIPS by 2005. This study investigates two questions in this context: (1) How does the introduction of product patents in pharmaceuticals affect the likelihood of pharmaceutical firms to launch new and innovative medicines in those markets? (2) For launched new and innovative medicines, how much do patent owners or generic pharmaceutical firms adjust their prices to local income levels? Using launch data from 1980 to 2017 covering 70 markets, the study finds that introduction of product patent for pharmaceuticals in the patent law has a positive effect on launch likelihood, especially for innovative pharmaceuticals. However, this effect is quite limited in low-income markets. Also, innovative pharmaceuticals are launched sooner than non-innovative ones, irrespective of the patent regime in the local market. Using a panel data set of originator and generic prices from 2007 to 2017, the study finds evidence of differential pricing for both originator and generic products. Overall, originators differentiate by about 11% and generics by about 26%. Differential pricing is larger for pharmaceuticals to treat infectious diseases, particularly for HIV/AIDs medicines, than for non-communicable diseases. However, pharmaceutical prices are far from being fully adjusted to local income levels in either case. However, competition, especially that within a particular medicine market, can effectively drive down prices in both originator and generic markets.
    Keywords: intellectual property rights,patents,TRIPS,pharmaceuticals,pharmaceutical prices,differential pricing,developing countries
    JEL: O34 I11 I19 F19
    Date: 2019
  5. By: Galasso, Alberto; Luo, Hong
    Abstract: We study the impact of consumers' risk perception on firm innovation. Our analysis exploits a major surge in the perceived risk of radiation diagnostic devices, following extensive media coverage of a set of over-radiation accidents involving CT scanners in late 2009. Difference-in-differences regressions using data on patents and FDA product clearances show that the increased perception of radiation risk spurred the development of new technologies that mitigated such risk and led to a greater number of new products. We provide qualitative evidence and describe patterns of equipment usage and upgrade that are consistent with this mechanism. Our analysis suggests that changes in risk perception can be an important driver of innovation and shape the direction of technological progress.
    Keywords: Innovation; medical devices; product liabilities; risk perception
    JEL: K13 O31 O32 O34
    Date: 2019–04
  6. By: Nizam, Ahmed Mehedi
    Abstract: Here, we propose a taxation scheme towards the implementation of universal health care under Beveridge model. In our proposed framework, a small amount of health tax is imposed on each and every non-cash transaction including transactions through debit and credit card, credit transfer, direct debit and cheque which is found to be solely sufficient to cover up entire health expenditure of a nation. We have shown empirically that a $1.84$ USD levy on every non-cash transaction is enough to meet up the annual health expenditure in the CEMEA (Central Europe, Middle East and Africa) region. For Latin America (LA), Emerging Asia (EA), Mature Asia and the Pacific (MAP) and North America (NA) this value is found to be $4.51$, $2.04$, $15.93$ and $21.07$ USD respectively. Moreover, as the proposed levy is collectable electronically without any human intervention, no additional logistic support is required for the implementation of the scheme.
    Keywords: Universal Health Care; Non-cash Transaction, Beveridge Model; Health Care Funding Model; Health Insurance
    JEL: I0 I1 I10 I13 I18 I31 I38
    Date: 2019–04–21
  7. By: Mochamad Pasha (Consultant, World Bank, Indonesia); Marc Rockmore (Department of Economics, Clark University, USA); Chih Ming Tan (Department of Economics, University of North Dakota, USA; Rimini Centre for Economic Analysis)
    Abstract: We study the effect of early life exposure to above average levels of rainfall on adult mental health. While we find no effect from pre-natal exposure, post-natal positive rainfall shocks decrease average Center for Epidemiological Studies Depression (CESD) mental health scores by 15 percent and increase the likelihood of depression by 5 percent, a more than 20 percent increase relative to the mean. These effects are limited to females. We rule out prenatal stress and income shocks as pathways and find evidence suggestive of increased exposure to disease.
    Keywords: fetal origins, early life shocks, rainfall, mental health, climate change, Indonesia
    JEL: I15 O12
    Date: 2019–04

This nep-hea issue is ©2019 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.