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on Health Economics |
| By: | Justin Polchlopek |
| Abstract: | The general consensus among health economists is that the increasing capability of medical providers— often called medical “technology”—is responsible for the majority of growth in medical expenditure. And yet, the principle means of understanding medical technology is through the use of total factor productivity, which, despite giving reasonable estimates of the magnitude of the effects, is not a theory of technology, leaving policymakers without effective tools for prediction. This paper develops a descriptive model of technology that may have interesting implications for health economics. The model suggests that the manner of diffusion of technology is critical, and when technology diffuses haphazardly, the effects on expenditure can be unexpectedly large. |
| Keywords: | Health Economics, Health Care Production, National Health Expenditures, Sraffian Economics, Total Factor Productivity, Input-Output Economics, Technological Diffusion Processes JEL Codes: B51, C67, D24, D57, I11, I12, O33 |
| Date: | 2011 |
| URL: | http://d.repec.org/n?u=RePEc:uta:papers:2011_10&r=hea |
| By: | Marie-Louise Leroux (CORE - Center of Operation Research and Econometrics [Louvain] - Université Catholique de Louvain); Pierre Pestieau (CORE - Center of Operation Research and Econometrics [Louvain] - Université Catholique de Louvain, CREPP - Center of Research in Public Economics and Population Economics - Université de Liège, CEPR - Center for Economic Policy Research - CEPR, EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - Ecole des Hautes Etudes en Sciences Sociales (EHESS) - Ecole des Ponts ParisTech - Ecole Normale Supérieure de Paris - ENS Paris); Grégory Ponthière (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - Ecole des Hautes Etudes en Sciences Sociales (EHESS) - Ecole des Ponts ParisTech - Ecole Normale Supérieure de Paris - ENS Paris) |
| Abstract: | This paper studies the design of the optimal non linear taxation in an economy where longevity varies across agents, and depends on three factors: longevity genes, health investment and farsightedness. Provided earnings, farsightedness and genes are correlated, governmental intervention can be justi.ed on two grounds: correction for a lack of farsightedness and redistribution across both earnings and genetic dimensions. Whether longevity-enhancing spending should be subsidized or taxed is shown to depend on the combined effects of myopia, self-selection and free-riding on the annuity returns. Our policy conclusions depend also on how productivity and genes are correlated, on the complementarity of genes and efforts in the survival function, and on how the government weights the welfare of heterogeneous agents. All in all, it might be desirable to tax longevity-enhancing spending. |
| Keywords: | optimal taxation ; longevity ; genetic background ; heterogeneity ; myopia |
| Date: | 2011–04–15 |
| URL: | http://d.repec.org/n?u=RePEc:hal:psewpa:halshs-00586236&r=hea |
| By: | Grégory Ponthière (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - Ecole des Hautes Etudes en Sciences Sociales (EHESS) - Ecole des Ponts ParisTech - Ecole Normale Supérieure de Paris - ENS Paris) |
| Abstract: | Whereas studies on the optimal taxation under endogenous longevity assume a fixed heterogeneity of lifestyles, this paper considers the optimal tax policy in an economy where unequal longevities are the unintended outcome of differences in lifestyles, and where lifestyles are transmitted across generations. For that purpose, we develop a three-period OLG model where the population, who ignores the negative impact of excessive work on longevity, is partitioned in two groups with different tastes for leisure, and follows an adaptation/imitation process à la Bisin and Verdier (2001). The optimal short-run and long-run Pigouvian taxes on wages are shown to differ, because the latter correct agents'myopia, but also internalize intergenerational externalities due to the socialization process. |
| Keywords: | longevity ; OLG model ; lifestyle ; socialization ; intergenerational externalities ; Pigouvian taxes |
| Date: | 2011–04–14 |
| URL: | http://d.repec.org/n?u=RePEc:hal:psewpa:halshs-00586010&r=hea |
| By: | Alassane Drabo (CERDI - Centre d'études et de recherches sur le developpement international - CNRS : UMR6587 - Université d'Auvergne - Clermont-Ferrand I) |
| Abstract: | This paper examines the link between health inequalities, air pollution and political institutions. In health economics literature, many studies have assessed the association between environmental degradation and health outcomes. This paper extends this literature by investigating how air pollution could explain health inequalities both between and within developing countries, and the role of political institutions in this relationship. Theoretically, we argue that differential in exposition to air pollution among income classes, prevention ability against health effect of environment degradation, capacity to respond to disease caused by pollutants and susceptibility of some groups to air pollution effect are sufficient to expect a positive link between air pollution and income related health inequality. Furthermore, in democratic countries, this heterogeneity in the health effect of pollution may be mitigated since good institutions favour universal health policy issues, information and advices about hygiene and health practices, and health infrastructures building. Our econometric results show that sulphur dioxide emission (SO2) and particulate matter (PM10) are in part responsible for the large disparities in infant and child mortalities between and within developing countries. In addition, we found that democratic institutions play the role of social protection by mitigating this effect for the poorest income classes and reducing the health inequality it provokes. |
| Keywords: | health inequality;air pollution;political institutions;social protection |
| Date: | 2011–04–11 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-00584997&r=hea |
| By: | Alassane Drabo (CERDI - Centre d'études et de recherches sur le developpement international - CNRS : UMR6587 - Université d'Auvergne - Clermont-Ferrand I) |
| Abstract: | In the economic literature it is generally found that trade openness affects environment through various channels. While the mechanisms through which trade is associated with pollution are largely investigated theoretically and empirically, the role played by each trade component has not yet received enough attention. This paper attempts to bridge this gap by examining the consequences of agricultural primary commodity export on population's health via physical environment degradation. Using panel data from 1991 to 2009, and instrumental variables technique, the findings suggest that agricultural primary commodity export increases agricultural methane and nitrous oxide emissions as well as water pollution (biological oxygen demand). This environmental degradation from trade worsens population's health (infant and child mortality rates, and life expectancy at birth). These results are robust to different subcomponents of primary agricultural export, to African sample, and to other environmental variables considered. |
| Keywords: | primary commodity;agriculture;Trade;environment;health;instrumental variables technique |
| Date: | 2011–04–14 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-00586034&r=hea |
| By: | Lavado, Rouselle F.; Pantig, Ida Marie T.; Ulep, Valerie Gilbert T.; Datu, Maria Blesila G.; Ortiz, Danica Aisa P.; Jimenez, Jeanette F.; and Banzon, Eduardo P. |
| Abstract: | As a recognition of the valuable role of private sector in the healthcare delivery system, this paper attempts to collate vital information on private hospitals in the Philippines. This paper looks at the different characteristics and structures of private hospitals sector with regard to geographical distribution, services, financing, human resource, and other information needed by policymakers, investors, and other interested stakeholders. To better understand the current health care delivery system in the country, other sections compare private hospitals vis-a-vis government-owned facilities. |
| Keywords: | health services delivery |
| Date: | 2011 |
| URL: | http://d.repec.org/n?u=RePEc:phd:dpaper:dp_2011-05&r=hea |
| By: | Stephen Hall; P. A. V. B. Swamy; George S. Tavlas |
| Abstract: | We propose a new generalization of the concept of cointegration that allows for the possibility that a set of variables are involved in an unknown nonlinear relationship. Although these variables may be unit-root non-stationary, there exists a nonlinear combination of them that takes account of such non-stationarity. We then introduce an estimation technique that allows us to test for the presence of this generalized cointegration in the absence of knowledge as to the true nonlinear functional form and the full set of regressors. We outline the basic stages of the technique and discuss how the issue of unit-root non-stationarity and cointegration affects each stage of the estimation procedure. We then apply this technique to the relationship between health expenditure and health outcomes, which is an important but controversial issue. A number of studies have found very little or no relationship between the level of health expenditure and outcomes. In econometric terms, if there is such a relationship then there should exist a cointegrating relationship between these two variables and possibly many others. The problem that arises is that we may be either unable to measure these other variables or that we do not know about them, in which case we may incorrectly find no relationship between health expenditures and outcomes. We then apply the concept of generalized cointegration; we obtain a highly significant relationship between health expenditure and health outcomes. |
| Keywords: | Generalized cointegration; non-stationarity; time-varying coefficient model; coefficient driver |
| JEL: | C13 C19 C22 |
| Date: | 2011–03 |
| URL: | http://d.repec.org/n?u=RePEc:lec:leecon:11/22&r=hea |
| By: | Mupela, Evans (UNU-MERIT); Mustarde, Paul (Virtual Development UK); Jones, Huw (Virtual Development UK) |
| Abstract: | This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. The paper presents this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization (WHO). This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any 'real-world' articulation of this technology must confront. |
| Keywords: | Telemedicine, Satellite, Primary health, Alma Ata |
| JEL: | O25 O41 O43 O47 F15 F43 |
| Date: | 2011 |
| URL: | http://d.repec.org/n?u=RePEc:dgr:unumer:2011002&r=hea |
| By: | O'Reilly, Jacqueline; Wiley, Miriam M. |
| Date: | 2011–01 |
| URL: | http://d.repec.org/n?u=RePEc:esr:wpaper:rb2010/4/5&r=hea |
| By: | Layte, Richard |
| Date: | 2011–01 |
| URL: | http://d.repec.org/n?u=RePEc:esr:wpaper:rb2010/4/1&r=hea |
| By: | Amitabh Chandra; Jonathan S. Skinner |
| Abstract: | In the United States, health care technology has contributed to rising survival rates, yet health care spending relative to GDP has also grown more rapidly than in any other country. We develop a model of patient demand and supplier behavior to explain these parallel trends in technology growth and cost growth. We show that health care productivity depends on the heterogeneity of treatment effects across patients, the shape of the health production function, and the cost structure of procedures such as MRIs with high fixed costs and low marginal costs. The model implies a typology of medical technology productivity: (I) highly cost-effective “home run” innovations with little chance of overuse, such as anti-retroviral therapy for HIV, (II) treatments highly effective for some but not for all (e.g. stents), and (III) “gray area” treatments with uncertain clinical value such as ICU days among chronically ill patients. Not surprisingly, countries adopting Category I and effective Category II treatments gain the greatest health improvements, while countries adopting ineffective Category II and Category III treatments experience the most rapid cost growth. Ultimately, economic and political resistance in the U.S. to ever-rising tax rates will likely slow cost growth, with uncertain effects on technology growth. |
| JEL: | D24 I1 I12 |
| Date: | 2011–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:16953&r=hea |
| By: | Adewara, Sunday Olabisi; Visser, Martine |
| Abstract: | We used 2008 DHS data sets to construct child height- and weight-for-age Z-scores and used regression analysis to analyze the effects of different sources of drinking water and sanitation on child health outcomes in Nigeria. We also calculated the probability of a child being stunted or underweight as our measure of malnutrition among children aged 0–59 months. Our results show that both child height and weight Z-scores are positive and significantly related to access to borehole and piped water, and negative and significant for well water. The probabilities of a child being stunted or underweight are both significantly lower for children drinking borehole or piped water, whereas well water has a positive and significant effect on these measures of child health. Children’s access to flush toilets is positive and significantly related to child height- and weight-for-age Z-scores, but the same measures are negatively related to children’s use of pit latrines. In line with this, the probability of a child being stunted or underweight is negative and significantly related to access to flush toilets, but positively related to pit latrines. Our results suggest that increasing access to, or providing, safe drinking water and flush toilets for households will significantly reduce the high incidence of malnutrition and water-borne diseases among children in Nigeria and should be a high priority for policymakers. |
| Keywords: | water, sanitation, weight-for-age Z-scores, height-for-age Z-scores, stunting, underweight, child, Nigeria |
| JEL: | D6 I1 I12 I21 Q5 |
| Date: | 2011–04–11 |
| URL: | http://d.repec.org/n?u=RePEc:rff:dpaper:dp-11-02-efd&r=hea |