Forum for Health Economics and PolicyThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

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32 records returned

`Me-Too' Innovation in Pharmaceutical MarketsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Critics of me-too innovation often argue that follow-on drugs offer little incremental clinical value over existing pioneer products, while at the same time increasing health care costs. We examine whether consumers view follow-on and pioneer drugs as close substitutes or distinct clinical therapies. For five major classes of drugs, we find that large reductions in the price of pioneer molecules after patent expiration--which would typically lead to decreased consumption of strong substitutes--have no effect on the trend in demand for follow-on drugs. Our findings are likely unaffected by health insurance, competitive pric...
Source: Forum for Health Economics and Policy - November 4, 2009 Category: Health Management Tags: Health Policy Source Type: journals

The Effects of Adolescent Health on Educational Outcomes: Causal Evidence Using Genetic Lotteries between SiblingsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present evidence that inattentive symptoms in early childhood have large lasting effects in reducing completed schooling. We also find little consistent evidence that adolescent overweight status influences years of schooling completed. (Source: Forum for Health Economics and Policy)
Source: Forum for Health Economics and Policy - September 25, 2009 Category: Health Management Tags: Health and Education Source Type: journals

Comparing Health of People with Heart Disease in the United States and CanadaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Our results indicate that people with heart disease are in better health in Canada as measured by disability, but there is no difference for overall self-reported health or functional impairment. Further research must be done to determine the cause of outcomes differences among heart disease patients. (Source: Forum for Health Economics and Policy)
Source: Forum for Health Economics and Policy - September 23, 2009 Category: Health Management Source Type: journals

The Cost of Primary Care DoctorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: At current levels of supply, the marginal social costs of primary care visits appear to be equal to or greater than marginal social benefits of many primary care services. In considering expansions of primary care capacity, it may be efficient to increase the use of complementary, lower-skilled practitioners. (Source: Forum for Health Economics and Policy)
Source: Forum for Health Economics and Policy - August 26, 2009 Category: Health Management Tags: Economics of Health Care Contracting Source Type: journals

On Inferring Demand for Health Care in the Presence of Anchoring and Selection BiasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the contingent valuation literature, anchoring bias poses problems when using an iterative bidding game to infer willingness to pay. This bias occurs when the willingness to pay estimate is sensitive to the initially presented starting value. More generally, whenever a survey format is used and not all of those contacted participate, selection bias raises concerns about the representativeness of the sample. In this paper, we estimate students' willingness to pay for student health care at Stanford University while accounting for both of these biases. As there is no cost sharing for students, we assess willingness to pay...
Source: Forum for Health Economics and Policy - July 17, 2009 Category: Health Management Tags: Health Economics Source Type: journals

A Bargain at Twice the Price? California Hospital Prices in the New MillenniumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We use data from California to document and offer possible explanations for the sharp increase in hospital prices charged to private payers after 1999. We find a downward trend in price for private pay patients in the 1990s and a rapid upward trend beginning in 1999, amounting to an annual average increase of 10.6% per year over 1999-2005. Prices in 2006 were almost double prices in 1999. By contrast, there was little discernable trend in prices for Medicare and Medicaid patients, although these prices varied from year-to-year. Surprisingly, the increase in prices is not correlated, geographically, with the change in hospi...
Source: Forum for Health Economics and Policy - July 10, 2009 Category: Health Management Tags: Health Economics Source Type: journals

Why the Poor Get Fat: Weight Gain and Economic InsecurityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Something about being poor makes people fat. Though there are many possible explanations for the income-body weight gradient, we investigate a promising but little-studied hypothesis: that changes in body weight can--at least in part--be explained as an optimal response to economic insecurity. We use data on working-age men from the 1979 National Longitudinal Survey of Youth (NLSY79) to identify the effects of various measures of economic insecurity on weight gain. We find in particular that over the 12-year period between 1988 and 2000, the average man gained about 21 pounds. A one percentage point (0.01) increase in the ...
Source: Forum for Health Economics and Policy - June 30, 2009 Category: Health Management Tags: Obesity Source Type: journals

The Effect of Smoking in Young Adulthood on Smoking Later in Life: Evidence based on the Vietnam Era Draft LotteryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
An important, unresolved question for health policymakers and consumers is whether cigarette smoking in young adulthood has lasting effects into later adulthood. The Vietnam era draft lottery offers an opportunity to address this question, because it randomly assigned young men to be more likely to experience conditions favoring cigarette consumption, including highly subsidized prices. Using this natural experiment, we find that military service increased the probability of smoking by 35 percentage points as of 1978-80, when men in the relevant cohorts were aged 25-30, but later in adulthood this effect was substantially ...
Source: Forum for Health Economics and Policy - June 9, 2009 Category: Health Management Tags: Smoking Source Type: journals

Health Insurance Demand and the Generosity of Benefits: Fixed Effects Estimates of the Price ElasticityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper explores a central question in health economics: How sensitive is worker demand for health insurance? After controlling for variables omitted in other analyses, such as the generosity of plan coverage and aspects of worker demand that are constant within firms over time, I estimate a price elasticity (between -0.014 and -0.017) which is smaller than previous estimates. The analysis also finds that employees are more likely to take-up policies with greater insurance protection from hospital expenses, but not for increased coverage for prescription drug or provider office visit expenses. Taken together, increases ...
Source: Forum for Health Economics and Policy - June 9, 2009 Category: Health Management Tags: Health Economics Source Type: journals

Longer Hours and Larger Waistlines? The Relationship between Work Hours and ObesityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Additional work hours may lead to weight gain by decreasing exercise, causing substitution from meals prepared at home to fast food and pre-prepared processed food, or reducing sleep. Substitution toward unhealthy convenience foods could also influence the weight of one's spouse and children, while longer work hours for adults may further impact child weight by reducing parental supervision. I examine the effects of adult work hours on the body mass index (BMI) and obesity status of adults as well as the overweight status of children. Longer hours increase one's own BMI and probability of being obese, but have a smaller an...
Source: Forum for Health Economics and Policy - May 27, 2009 Category: Health Management Tags: Obesity Source Type: journals

Changes in Spousal Health Insurance Coverage and Female Labor Supply DecisionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study examines the changing relationship between spousal health insurance coverage and labor market outcomes for married women over time as healthcare costs have increased. In particular, I investigate how husbands' health insurance coverage offers affect wives' decisions to enter the labor force and work full-time and how this has changed over time. I endeavor to correct for potential biases of these effects by 1) using an instrumental variables model to deal with endogeneity and 2) estimating and netting out likely unobserved heterogeneity biases, such as assortative mating or income effects. Using Current Populatio...
Source: Forum for Health Economics and Policy - May 1, 2009 Category: Health Management Tags: Health Economics Source Type: journals

Hospital Competition and Charity CareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper explores the relationship between competition and hospital charity care by analyzing changes in charity care associated with changes in a hospital's competitive environment (due to mergers and divestitures), using hospital financial and discharge data from Florida and Texas. Despite the pervasive belief that competition impedes a hospital's ability to offer services to the uninsured and under-insured, I find no statistically significant evidence that increased competition leads to reductions in charity care. In fact, I find some evidence that reduced competition leads to higher prices for uninsured patients. (So...
Source: Forum for Health Economics and Policy - May 1, 2009 Category: Health Management Tags: Health Economics Source Type: journals

The Impact of Children's Public Health Insurance Expansions on Educational OutcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper examines the impact of public health insurance expansions through both Medicaid and SCHIP on children's educational outcomes, measured by 4th and 8th grade reading and math test scores, available from the National Assessment of Educational Progress (NAEP). We use a triple difference estimation strategy, taking advantage of the cross-state variation over time and across ages in children's health insurance eligibility. Using this approach, we find that test scores in reading, but not math, increased for those children affected at birth by increased health insurance eligibility. A 50 percentage point increase in el...
Source: Forum for Health Economics and Policy - May 1, 2009 Category: Health Management Tags: Health Policy Source Type: journals

Quality Effect of Early Discharge of Maternity Patients: Does Hospital Specialization Matter?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The quest to reduce health care cost has led many industrialized nations to reduce hospital length of stay. This paper uses instrumental variable estimation to estimate the effect of early discharge on readmission rates of maternity patients in British Columbia, Canada and investigates how the impact varied according to hospitals' degree of specialization. Principal component analysis was used to classify the hospitals according to their degree of specialization. The results show that the early discharge policy increased readmission rates, and this increase, varied according to the degree of specialization of the hospital....
Source: Forum for Health Economics and Policy - December 9, 2008 Category: Health Management Tags: Health Economics Source Type: journals

Explanations for Persistent Nursing ShortagesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper contributes to the economics literature on nursing market shortages by putting forward two new models that suggest three new explanations for perceived nursing shortages. The first model focuses on hospitals hiring both permanent staff nurses and temporary contract nurses. It shows that hiring both classes of nurses can represent optimizing behavior, and that an interesting kind of perceived nursing shortage results from this dual hiring. The second model posits two classes of hospitals, ``premier" and ``funds-constrained," and generates two distinct kinds of nursing shortages: economic shortages, involving unfi...
Source: Forum for Health Economics and Policy - November 20, 2008 Category: Health Management Tags: Health Economics Source Type: journals

The Utilization of Medicines beyond Patent ExpirationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: Many medicines continue to be used far beyond their period of patent protection, somewhat countering the view that newer drugs quickly replace older ones. This extended, post-patent utilization can yield additional surplus for society that is over and above the surplus generated during the period of patent protection. (Source: Forum for Health Economics and Policy)
Source: Forum for Health Economics and Policy - November 20, 2008 Category: Health Management Tags: Health Policy Source Type: journals

State Health Insurance Regulations and the Price of High-Deductible PoliciesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study examines the impact of state health insurance regulations on the price of high-deductible family and individual polices in the nongroup market. We use a unique and rich data set on actual insurance policies sold through a large Internet health insurance distributor to examine the impact of various regulations on policy prices, controlling for policy characteristics, demographic characteristics of the purchasers, and state-level demographics. We also use data from a single major insurance firm that provided offer prices for a family policy from a set of randomly selected zip codes. Both datasets suggest a strong ...
Source: Forum for Health Economics and Policy - November 19, 2008 Category: Health Management Tags: Health Care Reform Source Type: journals

Dynamic Cost-Effectiveness: A More Efficient Reimbursement CriterionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Basing drug reimbursement on cost-effectiveness provides too little incentives for R&D. The reason for this is that cost-effectiveness is concerned with immediate value for money. But since the price of a drug usually declines over time, the drug might well provide value for money as seen over its entire life cycle, even though its price during patent protection is too high to warrant reimbursement according to the cost-effectiveness decision rule. We show in a theoretical model that welfare could be improved if decision-makers took a longer perspective and initially allowed higher prices than immediate value for money can...
Source: Forum for Health Economics and Policy - November 6, 2008 Category: Health Management Tags: Economics of Health Care Contracting Source Type: journals

The Reality of SCHIP and Uninsureds: Do SCHIP Mandatory Wait Periods Increase the Uninsured Rolls?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Due to the low risk of not insuring a healthy child for a short, finite period of time, it's plausible that SCHIP mandatory wait periods, where a child must forgo private insurance for several months before enrolling in SCHIP, do not provide enough incentive for parents to keep their children enrolled in private insurance. Using data from the 1996 Survey of Income and Program Participation (SIPP), we find that children eligible for SCHIP in states with shorter mandatory wait periods are more likely to be uninsured during the six months following the implementation of SCHIP than children in states with no mandatory wait per...
Source: Forum for Health Economics and Policy - October 6, 2008 Category: Health Management Tags: Health Policy Source Type: journals

State and Federal Approaches to Health Reform: What Works for the Working Poor?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We compare and contrast the labor market and distributional impact of three common approaches to state and federal health insurance expansion: public insurance expansions, refundable tax credits for low income people, and employer and individual mandates. We draw on existing estimates from the literature and individual-level data on the non-institutionalized population aged 64 and younger from the 2005 Current Population Survey to estimate how each approach affects (1) the number of people insured; (2) private and public health spending; (3) employment and wages; and (4) the distribution of subsidies across families based ...
Source: Forum for Health Economics and Policy - July 1, 2008 Category: Health Management Source Type: journals

Public Support for National Health Insurance: The Roles of Attitudes and BeliefsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The U.S. is the only developed country without some form of national health insurance. Yet, public opinion polls have consistently reported solid majorities in favor of such a system. In this paper, we examine whether attitudes toward different roles of government and beliefs that may be related to those attitudes are consistent with widespread support for national health insurance. Our analysis is based on the premise that a system of national health insurance would require government redistribution and government intervention in health care markets. We find that people who have favorable attitudes toward government econo...
Source: Forum for Health Economics and Policy - April 16, 2008 Category: Health Management Source Type: journals

Labor Market Consequences of State Mental Health Parity MandatesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper analyzes the effects of state mental health parity mandates on the labor and insurance markets. In particular, I investigate the effect of parity regulations along five margins: having employer provided health insurance coverage, employer contributions to health insurance premiums, the probability of full-time employment, working hours, and wages for a sample of private workers in firms with less than 100 employees using the Annual Demographic Surveys (March CPS) for the years 1999-2004 (and also in an extended sample of CPS 1992-2004). It is hypothesized that if parity mandates are costly they will have an impa...
Source: Forum for Health Economics and Policy - April 7, 2008 Category: Health Management Tags: Health Care Reform Source Type: journals

Consumer-Directed Health Plans and Health Savings Accounts: Have They Worked for Small Business?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cost has deterred many small businesses from providing health insurance to their workers. Consumer-directed health plans, which are potentially less costly than traditional health plans, may be well suited to workers in small businesses. We study the factors that are associated with CDHP offering, determine the variation in CDHP offering among large and small firms, and develop models of persistence in CDHP offering. Our analysis of the Kaiser-HRET survey shows that small firms have been no quicker in their uptake of CDHPs than larger firms, and appear to display somewhat more churning in CDHP offering than large firms. Sm...
Source: Forum for Health Economics and Policy - April 3, 2008 Category: Health Management Tags: Health Economics Source Type: journals

Health Status, Health Care and Inequality: Canada vs. the U.S.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It is often alleged that Canada's publicly-funded, single payer health care system, delivers better health outcomes, and distributes health resources more fairly than the mainly private U.S. multi-payer system. Our findings contradict these allegations. Differences between the U.S. and Canada in infant mortality and life expectancy --the two indicators most commonly used as evidence of better health outcomes in Canada--cannot be attributed to differences in the effectiveness of the two health care systems because they are strongly influenced by differences in cultural and behavioral factors such as the relatively high U.S....
Source: Forum for Health Economics and Policy - April 3, 2008 Category: Health Management Tags: Health Policy Source Type: journals

Can Multi-payer Financing Achieve Single-Payer Spending Levels?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many believe the high level of United States health care costs compared with other countries is attributable to high administrative costs inherent in our pluralistic health care financing system. Instead of the well known statistics examining the percentage of GDP that various countries spend on health care, which show the US as a large outlier, we show the percentage of Gross State Product various states spend on health care. Even adjusting for age and income, there is considerable variation across the states in spending levels, with the lowest quintile of states spending approximately the same percentage as the higher sp...
Source: Forum for Health Economics and Policy - April 1, 2008 Category: Health Management Tags: Health Economics Source Type: journals

Pharmaceutical Innovation and U.S. Cancer Survival, 1992-2003: Evidence from Linked SEER-MEDSTAT DataEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study examines the impact of pharmaceutical innovation and other factors on the survival of U.S. cancer patients during the period 1992-2003. In particular, it investigates whether cancer survival rates increased more for those cancer sites that had the largest increases in the proportion of chemotherapy treatments that were "new" treatments. We control for other types of medical innovation, i.e. other pharmaceutical innovation, and innovation in surgical procedures, diagnostic radiology procedures, and radiation oncology procedures. Data on observed survival rates, the number of people diagnosed, mean age at diagnosi...
Source: Forum for Health Economics and Policy - March 21, 2008 Category: Health Management Tags: Health Economics Source Type: journals

Large Health Savings Accounts: A Step toward Tax Neutrality for Health CareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The creation of tax-free health savings accounts presents a new opportunity to reduce the distortions created by federal tax preferences for health-related expenditures that ultimately could help eliminate those distortions. This paper proposes changes to current law that would allow most workers to receive the full amount that they and their employer spend on their health benefits as a tax-free cash contribution to the worker's health savings account. Restructuring the exclusion for employer-sponsored health benefits in this way would enable more individuals to obtain health insurance that matches their preferences, would...
Source: Forum for Health Economics and Policy - March 14, 2008 Category: Health Management Tags: Health Care Reform Source Type: journals

Hospital Quality and Selective Contracting: Evidence from Kidney TransplantationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Most private health insurers offer a limited network of providers to enrollees. Critics have questioned whether selective contracting benefits patients. Plans counter that they take quality into account when choosing providers. Using data on five plans' networks for kidney transplant hospitals, this study shows that in-network hospitals have better outcomes than out-of-network facilities. Conditional logit estimates using patient level data confirm this result: compared to Medicare patients, privately-insured patients are more likely to register at hospitals with higher survival rates. Restricting choice has the potential ...
Source: Forum for Health Economics and Policy - March 3, 2008 Category: Health Management Tags: Economics of Health Care Contracting Source Type: journals

Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral TreatmentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study we use administrative data from California's Medicaid program to estimate the impact of HIV antiretroviral treatments (ARVs). We use data on health care utilization to proxy for health status and exploit the rapid takeup of ARVs following their FDA approval. Our estimate of a 68 percent average mortality rate reduction is in line with the results from RACTs. We also find that the ARVs lowered short-term health care spending by reducing expenditures on other categories of medical care. Combining these two effects we estimate the cost per life year saved at $19,000. Our results suggest an alternative method for...
Source: Forum for Health Economics and Policy - January 29, 2008 Category: Health Management Tags: Economics of the HIV Epidemic Source Type: journals

Cross-Country Variation in Obesity Patterns among Older Americans and EuropeansEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
While the fraction of obese people is not as large in Europe as in the United States, obesity is becoming an important issue in Europe as well. Using comparable data from the Survey of Health, Aging and Retirement in Europe (SHARE) and the Health and Retirement Study in the U.S. (HRS), we analyze the correlates of obesity in the population ages 50 and above, focusing on measures of energy intake and expenditure as well as socio-economic status. We find that obesity rates differ substantially on both sides of the Atlantic and across European countries, with most of the difference coming from the right tail of the weight dis...
Source: Forum for Health Economics and Policy - January 3, 2008 Category: Health Management Tags: Aging and Medical Care Costs Source Type: journals

Willingness to Pay for Antiretroviral Therapy for HIV Positive Individuals in IndiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study analyses the demand for antiretroviral therapy (ART) using a contingent valuation approach, by estimating the willingness to pay for ART among a sample of HIV positive individuals in India. The study finds a very high willingness to be on ART, but substantially lower willingness to pay for it. To cover 70 percent of patients would require the price to be around Rs. 500 per month. Economic status generally and of females in particular have a positive relationship with the willingness to pay for drugs, whereas being a female exerts a downward pressure on the demand for ART. (Source: Forum for Health Economics and Policy)
Source: Forum for Health Economics and Policy - December 20, 2007 Category: Health Management Tags: Economics of the HIV Epidemic Source Type: journals

Current and Future Prevalence of Obesity and Severe Obesity in the United StatesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study examines past patterns and projects future prevalence rates of obesity and severe obesity among US adults. Trends in body mass index (BMI), overweight (BMI≥25), obesity (BMI≥30), class 2 obesity (BMI≥35), class 3 obesity (BMI≥40) and class 4 obesity (BMI≥45) of 20-74 year olds are obtained using data from the first National Health Examination Survey and the National Health and Nutrition Examination Surveys. Quantile regression methods are then used to forecast future prevalence rates through 2020. By that year, 77.6% of men are predicted to be overweight and 40.2% obese, with class 2, 3 and 4 obesity p...
Source: Forum for Health Economics and Policy - September 13, 2007 Category: Health Management Tags: Obesity Source Type: journals