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Journal of Health Economics

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https://www.readbyqxmd.com/read/28619488/financial-risk-protection-from-social-health-insurance
#1
Kayleigh Barnes, Arnab Mukherji, Patrick Mullen, Neeraj Sood
This paper estimates the impact of social health insurance on financial risk by utilizing data from a natural experiment created by the phased roll-out of a social health insurance program for the poor in India. We estimate the distributional impact of insurance on of out-of-pocket costs and incorporate these results with a stylized expected utility model to compute associated welfare effects. We adjust the standard model, accounting for conditions of developing countries by incorporating consumption floors, informal borrowing, and asset selling which allow us to separate the value of financial risk reduction from consumption smoothing and asset protection...
June 7, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28602394/reputational-concerns-with-altruistic-providers
#2
Pau Olivella, Luigi Siciliani
We study a model of reputational concerns when doctors differ in their degree of altruism and they can signal their altruism by their (observable) quality. When reputational concerns are high, following the introduction or enhancement of public reporting, the less altruistic (bad) doctor mimics the more altruistic (good) doctor. Otherwise, either a separating or a semi-separating equilibrium arises: the bad doctor mimics the good doctor with probability less than one. Pay-for-performance incentive schemes are unlikely to induce crowding out, unless some dimensions of quality are unobservable...
June 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28558295/the-effect-of-spending-cuts-on-teen-pregnancy
#3
David Paton, Liam Wright
In recent years, English local authorities have been forced to make significant cuts to devolved expenditure. In this paper, we examine the impact of reductions in local expenditure on one particular public health target: reducing rates of teen pregnancy. Contrary to predictions made at the time of the cuts, panel data estimates provide no evidence that areas which reduced expenditure the most have experienced relative increases in teenage pregnancy rates. Rather, expenditure cuts are associated with small reductions in teen pregnancy rates, a result which is robust to a number of alternative specifications and tests for causality...
May 17, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28558294/justification-bias-in-self-reported-disability-new-evidence-from-panel-data
#4
Nicole Black, David W Johnston, Agne Suziedelyte
The relationship between health and work is frequently investigated using self-assessments of disability from social surveys. The complication is that respondents may overstate their level of disability to justify non-employment and welfare receipt. This study provides new evidence on the existence and magnitude of justification bias by exploiting a novel feature of a large longitudinal survey: each wave respondents are asked identical disability questions twice; near the beginning and end of the face-to-face interview...
May 17, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28570914/the-health-consequences-of-aerial-spraying-illicit-crops-the-case-of-colombia
#5
Adriana Camacho, Daniel Mejía
This paper exploits variations in aerial spraying across time and space in Colombia and employs a panel of individual health records in order to study the causal effects of the aerial spraying of herbicides (glyphosate) on short-term health-related outcomes. Our results show that exposure to the herbicide used in aerial spraying campaigns increases the number of medical consultations related to dermatological and respiratory illnesses, as well as the number of miscarriages. These findings are robust to the inclusion of individual fixed effects, which compare the prevalence of these medical conditions for the same person under different levels of exposure to the herbicide used in the aerial spraying program over a period of 5 years...
May 13, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28551557/on-the-road-to-recovery-gasoline-content-regulations-and-child-health
#6
Michelle Marcus
Gasoline content regulations are designed to curb pollution and improve health, but their impact on health has not been quantified. By exploiting both the timing of regulation and spatial variation in children's exposure to highways, I estimate the effect of gasoline content regulation on pollution and child health. The introduction of cleaner-burning gasoline in California in 1996 reduced asthma admissions by 8% in high exposure areas. Reductions are greatest for areas downwind from highways and heavy traffic areas...
May 3, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28478344/the-gender-gap-in-mortality-how-much-is-explained-by-behavior
#7
Johannes Schünemann, Holger Strulik, Timo Trimborn
In developed countries, women are expected to live about 4-5 years longer than men. In this paper, we develop a novel approach to gauge the extent to which gender differences in longevity can be attributed to gender-specific preferences and health behavior. We set up a physiologically founded model of health deficit accumulation and calibrate it using recent insights from gerontology. From fitting life cycle health expenditure and life expectancy, we obtain estimates of the gender-specific preference parameters...
April 25, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28482215/solving-the-kidney-shortage-via-the-creation-of-kidney-donation-co-operatives
#8
K C Eames, Patrick Holder, Eduardo Zambrano
Many people object to the creation of a market for kidneys on the grounds that such reform would hurt those patients unable to afford the market price of a kidney and that donors do not understand the risks they are taking when donating. In this paper, we propose a mechanism, the kidney co-operative, designed to provide sufficient incentives to alleviate the kidney shortage while at the same time addressing the concerns regarding the potential losers from reform. We show that it is reasonable to expect that the number of transplants will be larger under the kidney co-operative mechanism than under either the status quo or a conventional market mechanism...
April 18, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28448950/promoting-innovation-in-small-markets-evidence-from-the-market-for-rare-and-intractable-diseases
#9
Toshiaki Iizuka, Gyo Uchida
In many medical care markets with limited profit potential, firms often have little incentive to innovate. These include the market for rare diseases, "neglected" tropical diseases, and personalized medicine. Governments and not-for-profit organizations promote innovation in such markets but empirical evidence on the policy effect is limited. We study this issue by analyzing the impact of a demand-side policy in Japan, which reduces the cost sharing of patients with some rare and intractable diseases and attempts to establish and promote the treatment of those diseases...
April 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28505541/retirement-blues
#10
Gabriel Heller-Sahlgren
This paper analyses the short- and longer-term effects of retirement on mental health in ten European countries. It exploits thresholds created by state pension ages in an individual-fixed effects instrumental-variable set-up, borrowing intuitions from the regression-discontinuity design literature, to deal with endogeneity in retirement behaviour. The results display no short-term effects of retirement on mental health, but a large negative longer-term impact. This impact survives a battery of robustness tests, and applies to women and men as well as people of different educational and occupational backgrounds similarly...
March 31, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28414953/health-shocks-and-their-long-lasting-impact-on-health-behaviors-evidence-from-the-2009-h1n1-pandemic-in-mexico
#11
Jorge M Agüero, Trinidad Beleche
Worldwide, the leading causes of death could be avoided with health behaviors that are low-cost but also difficult to adopt. We show that exogenous health shocks could facilitate the adoption of these behaviors and provide long-lasting effects on health outcomes. Specifically, we exploit the spatial and temporal variation of the 2009 H1N1 influenza pandemic in Mexico and show that areas with a higher incidence of H1N1 experienced larger reductions in diarrhea-related cases among young children. These reductions continue even three years after the shock ended...
March 31, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28340393/when-public-health-intervention-is-not-successful-cost-sharing-crowd-out-and-selection-in-korea-s-national-cancer-screening-program
#12
Hyuncheol Bryant Kim, Sun-Mi Lee
This study investigates the impact of and behavioral responses to cost sharing in Korea's National Cancer Screening Program, which provides free stomach and breast cancer screenings to those with an income below a certain cutoff. Free cancer screening substantially increases the screening take up rate, yielding more cancer detections. However, the increase in cancer detection is quickly crowded out by cancer detection through other channels such as diagnostic testing and private cancer screening. Further, compliers are much less likely to have cancer than never takers...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28319792/safety-regulation-in-professional-football-empirical-evidence-of-intended-and-unintended-consequences
#13
Andrew Hanson, Nicholas A Jolly, Jeremy Peterson
In response to increasing public awareness and negative long-term health effects of concussions, the National Football League implemented the "Crown-of-the-Helmet Rule" (CHR). The CHR imposes penalties on players who initiate contact using the top of the helmet. This paper examines the intended effect of this policy and its potential for unintended consequences. We find evidence supporting the intended effect of the policy- a reduction in weekly concussion reports among defensive players by as much as 32% (34% for all head and neck injuries), but also evidence of an increase in weekly lower extremity injury reports for offensive players by as much as 34%...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28319791/premium-subsidies-the-mandate-and-medicaid-expansion-coverage-effects-of-the-affordable-care-act
#14
Molly Frean, Jonathan Gruber, Benjamin D Sommers
Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28288356/the-effect-of-prices-on-nutrition-comparing-the-impact-of-product-and-nutrient-specific-taxes
#15
Matthew Harding, Michael Lovenheim
This paper provides an analysis of the role of prices in determining food purchases and nutrition using very detailed transaction-level observations for a large, nationally-representative sample of US consumers over the period 2002-2007. Using product-specific nutritional information, we develop a new method of partitioning the product space into relevant nutritional clusters that define a set of nutritionally-bundled goods, which parsimoniously characterize consumer choice sets. We then estimate a large utility-derived demand system over this joint product-nutrient space that allows us to calculate price and expenditure elasticities...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28285141/mitigating-the-consequences-of-a-health-condition-the-role-of-intra-and-interhousehold-assistance
#16
Michael Dalton, Daniel LaFave
The behavior of noncoresident family members motivates much of the literature on consumption smoothing, risk-sharing, and informal networks, yet little is known empirically on the topic due to a lack of data simultaneously observing multiple households in an extended family. This study utilizes genealogically linked longitudinal data to examine how extended family networks insure against financial risks from severely limiting health conditions. We find that nonhealth consumption of unmarried households declines in response to worsening health, whereas married households smooth expenditures in a way that is consistent with full insurance...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28273626/did-medicare-part-d-reduce-mortality
#17
Jason Huh, Julian Reif
We investigate the implementation of Medicare Part D and estimate that this prescription drug benefit program reduced elderly mortality by 2.2% annually. This was driven primarily by a reduction in cardiovascular mortality, the leading cause of death for the elderly. There was no effect on deaths due to cancer, a condition whose drug treatments are covered under Medicare Part B. We validate these results by demonstrating that the changes in drug utilization following the implementation of Medicare Part D match the mortality patterns we observe...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28242432/medicaid-family-spending-and-the-financial-implications-of-crowd-out
#18
Marcus Dillender
A primary purpose of health insurance is to protect families from medical expenditure risk. Despite this goal and despite the fact that research has found that Medicaid can crowd out private coverage, little is known about the effect of Medicaid on families' spending patterns. This paper implements a simulated instrumental variables strategy with data from the Consumer Expenditure Survey to estimate the effect of an additional family member becoming eligible for Medicaid on family-level health insurance coverage and spending...
May 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28380346/uncovering-waste-in-us-healthcare-evidence-from-ambulance-referral-patterns
#19
Joseph J Doyle, John A Graves, Jonathan Gruber
There is widespread agreement that the US healthcare system wastes as much as 5% of GDP, yet much less agreement on the source of the waste. This paper uses the effectively random assignment of patients to ambulance companies to generate comparisons across similar patients treated at different hospitals. We find that assignment to hospitals whose patients receive large amounts of care over the three months following a health emergency have only modestly better survival outcomes compared to hospitals whose patients receive less...
March 22, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28349865/bans-on-electronic-cigarette-sales-to-minors-and-smoking-among-high-school-students
#20
Rahi Abouk, Scott Adams
Many states have banned electronic cigarette sales to minors under the rationale that using e-cigarettes leads to smoking traditional combustion cigarettes. Such sales bans would be counterproductive, however, if e-cigarettes and traditional cigarettes are substitutes, as bans might push teenagers back to smoking the more dangerous combustion cigarettes. We provide evidence that these sales bans reduce the incidence of smoking conventional cigarettes among high school seniors. Moreover, we provide evidence suggesting that sales bans reduced e-cigarette usage as well...
March 18, 2017: Journal of Health Economics
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