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Journal of Health Economics

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https://www.readbyqxmd.com/read/28712437/the-long-term-effects-of-consumer-directed-health-plans-on-preventive-care-use
#1
Matthew D Eisenberg, Amelia M Haviland, Ateev Mehrotra, Peter J Huckfeldt, Neeraj Sood
"Consumer-Directed" Health Plans (CDHPs), those with high deductibles and personal medical accounts, have been shown to reduce health care spending. The impact of CDHPs on preventive care is unclear. On the one hand CDHPs might increase use of preventive care as such care is exempt from the deductible. However, CDHPs also decrease visits to physicians which might results in less screening. Prior research has found conflicting results. In this study, using data from 37 employers we examine the effects of CDHPs on the use of cancer screenings up to three years after the initial CDHP offering with ITT and LATE approaches...
June 27, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28655489/the-spillover-effects-of-health-insurance-benefit-mandates-on-public-insurance-coverage-evidence-from-veterans
#2
Xiaoxue Li, Jinqi Ye
This study examines how regulations in private health insurance markets affect coverage of public insurance. We focus on mental health parity laws, which mandate private health insurance to provide equal coverage for mental and physical health services. The implementation of mental health parity laws may improve a quality dimension of private health insurance but at increased costs. We graphically develop a conceptual framework and then empirically examine whether the regulations shift individuals from private to public insurance...
June 13, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28619488/financial-risk-protection-from-social-health-insurance
#3
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
#4
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/28558294/justification-bias-in-self-reported-disability-new-evidence-from-panel-data
#5
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
#6
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
#7
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
#8
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/28641741/editorial-changes
#9
EDITORIAL
John Cawley, Martin Chalkley, Michael Chernew, Maarten Lindeboom, Ellen Meara, Nigel Rice, Luigi Siciliani, Andrew Street
No abstract text is available yet for this article.
July 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28558295/the-effect-of-spending-cuts-on-teen-pregnancy
#10
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...
July 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28482215/solving-the-kidney-shortage-via-the-creation-of-kidney-donation-co-operatives
#11
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...
July 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
#12
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...
July 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28380346/uncovering-waste-in-us-healthcare-evidence-from-ambulance-referral-patterns
#13
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...
July 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28349864/why-does-the-health-of-mexican-immigrants-deteriorate-new-evidence-from-linked-birth-records
#14
Osea Giuntella
This study uses a unique dataset linking the birth records of two generations of children born in California and Florida (1970-2009) to analyze the mechanisms behind the generational decline observed in birth outcomes of children of Mexican origin. Calibrating a simple model of intergenerational transmission of birth weight, I show that modest positive selection on health at the time of migration can account for the initial advantage in birth outcomes of second-generation Mexicans. Moreover, accounting for the socioeconomic differences between second-generation Mexicans and white natives and the observed intergenerational correlation in birth weight, the model predicts a greater deterioration than that observed in the data...
July 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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