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Author: Jason Alan Snyder
Publisher:
ISBN: 9780542826580
Category :
Languages : en
Pages : 260
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Book Description
This dissertation examines three important topics in healthcare and political economy. The unifying theme behind this dissertation is to examine the process of getting a job and keeping a job in health and political labor markets.
Author: Jason Alan Snyder
Publisher:
ISBN: 9780542826580
Category :
Languages : en
Pages : 260
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Book Description
This dissertation examines three important topics in healthcare and political economy. The unifying theme behind this dissertation is to examine the process of getting a job and keeping a job in health and political labor markets.
Author: Marco D. Huesch
Publisher:
ISBN:
Category : Health services administration
Languages : en
Pages : 522
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Author: Esteban Jose Mendez Chacon
Publisher:
ISBN:
Category :
Languages : en
Pages : 224
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Book Description
This dissertation consists of two lines of research. The first line focuses on decision making under uncertainty. Specifically, I analyze the nature of risk preferences in life-insurance choices, and I examine adverse selection and moral hazard in private-healthcare markets in a context where the government provides universal healthcare. The second line focuses on the political economy of institutions, and I study the impact of a multinational company on the economic development of its host country during and after its tenure. In Chapter 1, I estimate a structural model of risk preferences from the choice of insured amount in life-insurance contracts. The literature investigating life-insurance purchases has mostly focused on survey data to estimate how demand for insurance depends on demographic and socioeconomic factors, leaving aside the task of estimating an underlying model of decision making that generates this demand. Using proprietary data on life-insurance choices, I estimate a model of risky choice to explain households' decisions. My results indicate that, in addition to standard risk aversion (decreasing marginal utility for wealth), including decision weights that might differ from the actual probabilities improves the fit of the model. These weights can be interpreted as a combination of state-dependent utility and probability distortions. Moreover, I find support for the existence of heterogeneity in preferences. Women are more risk averse than men, and the decision weights vary depending on gender and age. In Chapter 2, we investigate adverse selection and moral hazard in private healthcare in markets where the government provides universal healthcare. We use proprietary data on health-insurance choices and medical expenditures to examine asymmetric information in this institutional setting. We disentangle adverse selection and moral hazard by leveraging variation in copays and deductibles implemented by the insurance company, and the fact that, for a sample of customers, the insured amount was exogenously assigned, shutting down the adverse selection channel. We find evidence for the presence of asymmetric information, both in the form of adverse selection and moral hazard. Moreover, we develop a model that incorporates sources of heterogeneity that could potentially explain selection in this institutional setting, namely risk aversion, risk type, concern for health, and taste for convenience services offered in the private healthcare sector. In Chapter 3, we analyze the impact of large-scale FDI on economic development by studying the case of the United Fruit Company (UFCo) in Costa Rica from 1889 to 1984. We implement a geographic regression discontinuity design that exploits a quasi-random assignment of land, and census data geo-referenced at the census-block level for 1973, 1984, 2000 and 2011. These allow us to identify the company's effect during its tenure, and after it stopped production. We find that former "UFCo lands" have had higher living standards and better economic outcomes than counterfactual areas without the company's presence, and that convergence is slow. These findings are validated using nighttime lights data. Detailed historical data suggest that the mechanisms behind our results are.
Author: Wesley Yin
Publisher:
ISBN:
Category :
Languages : en
Pages : 137
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Author: John B. McKinlay
Publisher: Taylor & Francis
ISBN: 9780422780506
Category : Social Science
Languages : en
Pages : 294
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Author: Sean McEwan Nicholson
Publisher:
ISBN:
Category :
Languages : en
Pages : 316
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Author: Joan Costa-Font
Publisher: Cambridge University Press
ISBN: 1108664059
Category : Political Science
Languages : en
Pages : 237
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Book Description
The healthcare sector is one of the fastest growing areas of social and public spending worldwide, and it is expected to increase its government shares of GDP in the near future. Truly global in its scope, this book presents a unified, structured understanding of how the design of a country's health institutions influence its healthcare activities and outcomes. Building on the 'public choice' tradition in political economy, the authors explore how patient-citizens interact with their country's political institutions to determine the organisation of the health system. The book discusses a number of institutional influences of a health system, such as federalism, the nature of collective action, electoral competition, constitutional designs, political ideologies, the welfare effects of corruption and lobbying and, more generally, the dynamics of change. Whilst drawing on the theoretical concepts of political economy, this book describes an institution-grounded analysis of health systems in an accessible way. We hope it will appeal to both undergraduate and graduate students studying health economics, health policy and public policy. More generally, it can help health policy community to structure ideas about policy and institutional reform.
Author: Archita Banik
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Author: Patrick Manzi
Publisher:
ISBN:
Category :
Languages : en
Pages : 111
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Author: Alexander Lee Olssen
Publisher:
ISBN:
Category :
Languages : en
Pages : 142
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Book Description
This thesis comprises three essays on the industrial organization of health care markets. In the first essay, joint with Mert Demirer, I study how formulary–contingent rebates affect insurers formulary placement of branded statins. The prices charged for on–patent, branded pharmaceuticals represent a large, and controversial, component of medical spending in the U.S. In contrast to many countries and many other government programs, drug prices in the Medicare Part D program are determined by privately negotiated rebates between insurance plans and drug manufacturers. How large are these rebates? What would happen to formularies, consumer surplus, and firm profits if the government could increase the rebates of a blockbuster Medicare Part D drug? We estimate a simultaneous model of insurance demand and statin demand for the population of statin users in 2010. Our demand estimates allow us to quantify how insurer profits change under different statin formulary structures. We use these profit functions to estimate the rebates for Crestor and Lipitor, two blockbuster drugs, using a moment inequality approach; we estimate rebates between 25% and 54% for branded statins. In counterfactuals, we analyze the effect of rebates on formulary design and consumer surplus. We show that increasing only Crestor rebates has no effect on consumer surplus because of offsetting effects on winners and losers. In contrast, increasing only Lipitor rebates does increase consumer surplus. If rebates reduced U.S. prices to match those paid in Canada, then consumer surplus would increase by up to 3.1% In the second essay, I compare estimates of formulary–contingent rebates using three empirical moment inequality models. Unobserved private rebates are an important determinant of the prices that insurers pay drug manufacturers in Medicare Part D. There is growing interest in understanding these negotiated rebates and there consequences on market equilibrium. However rebates are secret and have proven difficult to estimate. In this paper I compare three moment inequality models that I use to estimate formulary–contingent rebates for branded statins. The first model, which only allows for measurement error, imposes the strong assumption that their is no rebate heterogeneity that is unobserved to the econometrician. Due to the fact that different insurers use different agents (Pharmacy Benefit Mangers) in rebate negotiations, this assumption is unlikely to hold. As a consequence I develop two models that allow for unrestricted insurer–specific unobserved rebate heterogeneity. Somewhat surprisingly, the measurement errors only model produces reasonable results in this context, however the rebates for Lipitor are approximately twice as large in my preferred model relative to the measurement errors only model. In the third essay, also joint with Mert Demirer, I study the effects of government negotiated drug prices using Nash–in–Nash bargaining models. One of the most controversial aspects of Medicare Part D is that the government is prohibited from being involved in price negotiations despite the fact that it provides almost $100 billion to the program in subsidies each year. We model pharmaceutical drug price setting using Nash–in–Nash bargaining models. We compare two models: one where insurers negotiate drug prices and another where the government negotiates prices. We show that the ability for the government to improve consumer surplus depends on both upstream and downstream market structure. With many insurers and few drug manufacturers, the government can increase consumer surplus, but with few insurers the government cannot increase consumer surplus no matter how much bargaining power it has vis–a–vis drug manufacturers. We also show that a Nash–in–Nash bargaining model where insurers and drug manufacturers negotiate over both manufacturer prices and copays can be used to estimate unobservable manufacturer prices and bargaining weights as long as there are profit spillovers across bilateral negotiations.
