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on Health Economics |
| By: | Yasser MOULLAN (Centre d'Economie de la Sorbonne(CES-CNRS UMR 8174), UniversitŽ de Paris 1) |
| Abstract: | This paper analyses the impact of foreign health aid on the emigration rates of physicians. We use a panel database to investigate the emigration of physicians from 192 source countries to 17 destination countries between 1995 and 2004. First, we investigate the direct impact of health assistance using the generalised method of moments (GMM) and highlight a significant negative effect of foreign health assistance on the medical brain drain. Moreover, we analyse whether this effect of health aid is more effective in a context of good governance. We find that health aid is more effective at reducing physicians' emigration rates when the levels of corruption and inflation are low. |
| Keywords: | International Migration, Physicians Emigration Rates, Foreign Aid, Foreign health assistance |
| JEL: | F22 F35 O15 C23 I1 O11 |
| Date: | 2009–12–03 |
| URL: | http://d.repec.org/n?u=RePEc:ctl:louvir:2009039&r=hea |
| By: | Dean Baker; Hye-Jin Rho |
| Abstract: | The huge gap between the cost of health care in the United States and the cost in other countries with comparable health care outcomes suggests the potential for substantial gains from trade. This paper describes one mechanism for taking advantage of these gains – through a globalization of the country’s Medicare and Medicaid programs. The projections in this paper suggest that the country’s long-term budget situation would be substantially improved if beneficiaries of these two programs over the age of 65 were allowed to take advantage of the lower-cost health care available in other countries (that also have higher life expectancies than the U.S.). This could also allow them to enjoy much higher retirement incomes than they would otherwise receive. |
| Keywords: | Free Trade, healthcare, Medicare, Medicaid |
| JEL: | F F1 I I1 I11 I18 |
| Date: | 2009–10 |
| URL: | http://d.repec.org/n?u=RePEc:epo:papers:2009-38&r=hea |
| By: | Shawn Fremstad |
| Abstract: | Leading health care reform proposals all require individuals to obtain health care coverage, but differ in how they would require employers to share in the costs of coverage for their employees. This report reviews the employer responsibility requirements in the leading proposals—often referred to as “play-or-pay” provisions—and makes recommendations on how to best structure such a requirement to ensure that relatively low paid workers are not negatively impacted by them. |
| Keywords: | health care |
| JEL: | I I1 I18 I3 I38 H H2 H5 D D6 |
| Date: | 2009–09 |
| URL: | http://d.repec.org/n?u=RePEc:epo:papers:2009-33&r=hea |
| By: | Shawn Fremstad |
| Abstract: | Leaders in both the House and the Senate have committed to "shared responsibility" as a basic principle of health care reform, meaning that the costs of health care coverage are shared by individuals, businesses, and the public sector. However, as this issue brief documents, the Senate version of the bill creates a free rider problem that would make it easy for many large and profitable employers, particularly the ones paying poor wages, to shirk their responsibilities. |
| Keywords: | health care |
| JEL: | I I1 I18 I3 I38 H H2 H5 D D6 D63 |
| Date: | 2009–12 |
| URL: | http://d.repec.org/n?u=RePEc:epo:papers:2009-49&r=hea |
| By: | Kuchinke, Björn A.; Zerth, Jürgen; Wiese, Nadine |
| Abstract: | In the international health care literature there is a broad discussion on impacts of competition in health care markets. But aspects of standardization in regional health care markets with no price competition received comparatively little attention. We use a typical Hotelling-framework (reference case) to analyze a regional health care market with two health care providers competing in (vertical) quality after the scope of medical treatment is set (horizontal quality). We conclude, that in the reference case both health care provider will use vertical quality to separate from each other. In the next step (standardization case) we introduce one health care provider to be the standard leader in vertical quality. In the standardization case a more homogeneous supply can be expected. But, there is a higher possibility that the standard follower has to leave the regional health care market. -- |
| Date: | 2009 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:tuiedp:66&r=hea |
| By: | Basinga, Paulin; Gertler, Paul J.; Binagwaho, Agnes; Soucat, Agnes L.B.; Sturdy, Jennifer R.; Vermeersch, Christel M.J. |
| Abstract: | Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities'input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes. |
| Keywords: | Health Monitoring&Evaluation,Population Policies,Health Systems Development&Reform,Disease Control&Prevention,Adolescent Health |
| Date: | 2010–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wbrwps:5190&r=hea |
| By: | Just, David R.; Wansink, Brian; Mancino, Lisa; Guthrie, Joanne |
| Abstract: | Changing small factors that influence consumer choice may lead to healthier eating within controlled settings, such as school cafeterias. This report describes a behavioral experiment in a college cafeteria to assess the effects of various payment options and menu selection methods on food choices. The results indicate that payment options, such as cash or debit cards, can significantly affect food choices. College students using a card that prepaid only for healthful foods made more nutritious choices than students using either cash or general debit cards. How and when individuals select their food can also influence food choices. College students who preselected their meals from a menu board made significantly different food choices than students who ordered their meals while viewing the foods in line. |
| Keywords: | Behavioral economics, healthy eating, diet quality, food choices, school meal programs, experimental economics, ERS, USDA., Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety, Health Economics and Policy, Institutional and Behavioral Economics, Teaching/Communication/Extension/Profession, |
| Date: | 2008–12 |
| URL: | http://d.repec.org/n?u=RePEc:ags:uersrr:56489&r=hea |
| By: | Gary V. Engelhardt; Jonathan Gruber |
| Abstract: | We examine the impact of the expansion of public prescription prescription-drug insurance coverage from Medicare Part D has had on the elderly and find evidence of substantial crowd-out. Using detailed data from the 2002-6 waves of the Medical Expenditure Panel Survey (MEPS), we estimate that the extension of Part D benefits resulted in 75% crowd-out of prescription drug insurance coverage and 33%-50% crowd-out of prescription drug expenditures of those 65 and older. Part D is associated with relatively small reductions in out-of-pocket spending. This suggests that the welfare gain from protecting the elderly from out-of-pocket spending risk through Part D has been small. |
| Date: | 2009–10 |
| URL: | http://d.repec.org/n?u=RePEc:crr:crrwps:wp2009-24&r=hea |
| By: | Aureo de Paula (Department of Economics, University of Pennsylvania); Gil Shapira (Department of Economics, University of Pennsylvania); Petra E. Todd (Department of Economics, University of Pennsylvania) |
| Abstract: | This paper examines whether and to what extent changes in beliefs about own HIV status induce changes in risky sexual behavior using data from married males living in three regions of Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs. The empirical analysis is based on panel surveys for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP), which contain detailed information on beliefs about HIV status and on sexual behaviors. Many individuals change their beliefs over time, because of opportunities to get tested for HIV and informational campaigns. We estimate the effect of belief revisions on the propensity to engage in extra-marital affairs using a panel data estimator developed by Arellano and Carrasco (2003), which accommodates unobserved heterogeneity as well as belief endogeneity arising from the dependence of current beliefs on lagged behaviors. We find that downward revisions in the belief of being HIV positive lead to an increased propensity to engage in extra-marital affairs and upward revisions to a decreased propensity. The estimates are shown to be robust to underreporting of affairs. Using our estimates and a standard epidemeological model of disease transmission, we find that increasing the responsiveness of beliefs to test results would reduce the HIV transmission rate as infected individuals reduce sexual behavior and decrease the likelihood that uninfected persons have contact with an HV-positive person. |
| Keywords: | AIDS, Malawi, Beliefs |
| JEL: | I12 |
| Date: | 2009–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:pen:papers:10-004&r=hea |