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on Health Economics |
| By: | Richard Layard |
| Abstract: | This lecture argues that mental health is a major factor of production. It is the biggest single influence on life satisfaction, with mental health eight years earlier a more powerful explanatory factor than current income. Mental health also affects earnings and educational success. But, most strikingly, it affects employment and physical health. In advanced countries mental health problems are the main illness of working age - amounting to 40% of all illness under 65. They account for over one third of disability and absenteeism in advanced countries. They can also cause or exacerbate physical illness. It is estimated that in the absence of mental illness, the costs of physical healthcare for chronic diseases would be one third lower. The good news is that cost-effective treatments for the most common mental illnesses now exist (both drugs and psychological therapy). But only a quarter of those who suffer are in treatment. Yet psychological therapy, such as cognitive behavioural therapy, if more widely available would pay for itself in savings on benefits and lost taxes. The lecture ends by illustrating how rational policy can be made using life-course models of wellbeing. Such policies should include a much greater role for the treatment and prevention of mental illness. |
| Keywords: | mental health, wellbeing, employment |
| JEL: | I30 J30 |
| Date: | 2013–05 |
| URL: | http://d.repec.org/n?u=RePEc:cep:cepdps:dp1213&r=hea |
| By: | Wei Sun; Anthony Webb |
| Abstract: | The prospect of paying for nursing home care represents a significant financial risk for older Americans. Despite this risk, few individuals buy long-term care insurance and, since many lack the resources to pay out of pocket, they often turn to the means-tested Medicaid program. Concerned about growing Medicaid costs, many states have initiated “partnership” programs that offer a unique incentive for those who buy long-term care insurance: the state relaxes Medicaid’s asset test so that, if the private insurance benefits run out, individuals can retain more of their assets while still being eligible for Medicaid. This brief, which is based on a longer paper, estimates whether these enhanced insurance policies are likely to reduce Medicaid spending on single men and women. The brief is organized as follows. The first section describes the long-term care cost challenge and introduces the partnership programs. The second section explains the methodology for analyzing the programs’ impact on Medicaid outlays. The third section presents the results, which suggest that most of the buyers are those who would otherwise have purchased a traditional – unenhanced – policy. Thus, the final section concludes that, on balance, Medicaid will lose money on the partnership programs. |
| Date: | 2013–04 |
| URL: | http://d.repec.org/n?u=RePEc:crr:issbrf:ib2013-6&r=hea |
| By: | Peter Eibich; Nicolas R. Ziebarth |
| Abstract: | This paper exploits rich SOEP microdata to analyze state-level variation in health care utilization in Germany. Unlike most studies in the field of the Small Area Variation (SAV) literature, our approach allows us to net out a large array of individual-level and state-level factors that may contribute to the geographic variation in health care utilization. The raw data suggest that state-level hospitalization rates vary from 65 percent to 165 percent of the national mean. Ambulatory doctor visits range from 90 percent to 120 percent of the national mean. Interestingly, in the former GDR states doctor visit rates are significantly below the national mean, while hospitalization rates lie above the national mean. The significant state-level differences vanish once we control for individual-level socio-economic characteristics, the respondents’ health status, their health behavior as well as supply-side state-level factors. |
| Keywords: | Small area variation, health care utilization, SOEP |
| JEL: | I12 I14 I18 |
| Date: | 2013 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp551&r=hea |
| By: | Laun, Tobias (Uppsala Center for Fiscal Studies); Wallenius, Johanna (Department of Economics, Stockholm School of Economics) |
| Abstract: | In this paper we study the role of social insurance, namely old-age pensions, disability insurance and healthcare, in accounting for the differing labor supply patterns of older individuals across OECD countries. To this end, we develop a life cycle model of labor supply and health with heterogeneous agents. The key features of the framework are: (1) people choose when to stop working, and when/if to apply for disability and pension benefits, (2) the awarding of disability insurance benefits is imperfectly correlated with health, and (3) people can partially insure against health shocks by investing in health, the cost of which is dependent on health insurance coverage. We find that the incentives faced by older workers differ hugely across countries. In fact, based solely on differences in social insurance programs, the model predicts even more cross-country variation in the employment rates of people aged 55-64 than we observe in the data. |
| Keywords: | Life cycle; Retirement; Disability insurance; Health |
| JEL: | E24 J22 J26 |
| Date: | 2013–05–03 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:uufswp:2013_006&r=hea |
| By: | Elena Villalba Mora (European Commission – JRC - IPTS) |
| Abstract: | The SIMPHS 2 project has carried out in-depth studies in eight EU countries. Deliverable 3.1 ‘Interim Report on RMT for Disease Management – Country Studies Summary’ summarises the methods used and the rationale for selection of the countries for deeper analysis. It also highlights the main findings of the studies. The annexes include the eight reports in alphabetical order: Denmark, Estonia, France, Germany, Italy, Spain, The Netherlands and the United Kingdom. |
| Keywords: | Integrated care, telehealth, telecare, ICT, governance, innovation, impact assessment |
| JEL: | I11 I18 O33 O38 |
| Date: | 2012–03 |
| URL: | http://d.repec.org/n?u=RePEc:ipt:iptwpa:jrc71143&r=hea |
| By: | Joseph J. Capuno; Stella A. Quimbo; Aleli D. Kraft; Carlos Antonio R. Tan, Jr. (School of Economics, University of the Philippines Diliman) |
| Abstract: | We investigate the effects of two accountability measures on the decisions of the local governments under decentralization. Using a panel of Philippine municipalities and cities in three election years, we find that term limits have negative but weak effects on the provision of health insurance coverage to poor families and on expenditures on local services. However, yardstick competition (i.e., more subsidized insurance coverage for the poor in neighboring local governments) induces them to cover more poor families, but also reduce other public expenditures. To respond to critiques of health decentralization, our results suggest that the objectives of local politicians can be aligned with those of the health sector. The key insight is the incumbent may extend health insurance coverage like a redistributive transfer to pursue reelection objectives. However, the resulting trade off between subsidized insurance coverage and other public services must be considered. |
| Keywords: | Local governments, term limits, yardstick competition, health insurance, poor, Philippines |
| JEL: | H72 I18 H4 |
| Date: | 2012–01 |
| URL: | http://d.repec.org/n?u=RePEc:phs:dpaper:201201&r=hea |
| By: | Carlos Antonio R. Tan, Jr.; Joseph J. Capuno (School of Economics, University of the Philippines Diliman) |
| Abstract: | The treatment of drinking water is advocated to reduce the incidence of child diarrhea. However, evaluating the impact of water treatment with only observational data leads to biased estimates since it could be the occurrence of child diarrhea that induced the household to treat their drinking water. To deal with the possible simultaneity between the treatment of drinking water and the incidence of child diarrhea, we specify non-recursive two-equation causal models and apply it on a sub-sample of households with children below five years old from the Philippine National Demographic and Health Surveys. In the treatment effects model, we find that the treatment of drinking water reduces by 5.2 percentage points the proportion of under-5 children afflicted with diarrhea. In the instrumental-variable probit model, we find that households have a higher propensity to sterilize their drinking water by 1.2 percentage points given a one percentage point increase in the proportion of under-5 children with diarrhea. Ignoring the simultaneity yields the misleading result that water treatment increases the incidence child diarrhea. These results underscore the need to insure the quality of drinking water at the point of use and not just at the point of source. |
| Keywords: | causal effects, household water treatment, child diarrhea |
| JEL: | I12 I18 H51 |
| Date: | 2012–01 |
| URL: | http://d.repec.org/n?u=RePEc:phs:dpaper:201202&r=hea |
| By: | Andrei Barbos (Department of Economics, University of South Florida); Yi Deng (Department of Economics, University of South Florida) |
| Abstract: | We develop a framework where to examine the implications of the introduction of a non- profit "public option" in the U.S. health insurance market. In this model, a continuum of heterogeneous consumers, each facing unknown medical expenditures, and differing in their expectations of such expenditures, have to choose between two competing plans. One plan is offered by a profit-maximizing private insurer; the other by social-welfare-maximizing public option. The model is calibrated based on data of U.S. medical expenditures and estimation of a Bayesian hierarchical model. The Nash Equilibrium of the resulting market structure is solved using a numerical algorithm. In equilibrium, the distinct objectives of the two insurers induce adverse selection in consumer choice: the public option covers the less healthy consumers, yielding the more profitable segment of market to the private insurer. However, our empirical results suggest that both insurers will capture significant parts of the health insurance market. |
| Keywords: | Public Health Insurance, Bayesian Hierarchial Model |
| JEL: | I11 L10 L21 L32 |
| Date: | 2013–01 |
| URL: | http://d.repec.org/n?u=RePEc:usf:wpaper:0813&r=hea |
| By: | World Bank |
| Keywords: | Law and Development - Health Law Governance - Youth and Governance Services and Transfers to Poor Health Monitoring and Evaluation Health Systems Development and Reform Health, Nutrition and Population Poverty Reduction |
| Date: | 2012–05 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:10414&r=hea |
| By: | Christophe Lemière; Vincent Turbat; Juliette Puret |
| Keywords: | Law and Development - Health Law Health, Nutrition and Population - Population Policies Health Monitoring & Evaluation Health Systems Development & Reform Disease Control & Prevention |
| Date: | 2012–05 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:11880&r=hea |
| By: | World Bank |
| Keywords: | Agricultural Knowledge & Information Systems Health Monitoring & Evaluation Disease Control & Prevention Livestock & Animal Husbandry Avian Flu Health, Nutrition and Population Agriculture |
| Date: | 2012–06 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:11892&r=hea |
| By: | Maria Eugenia Bonilla Chacin |
| Keywords: | Health, Nutrition and Population - Adolescent Health Health, Nutrition and Population - Population Policies Health Monitoring and Evaluation Disease Control and Prevention Gender - Gender and Health Health Nutrition and Population |
| Date: | 2012–05 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:12417&r=hea |
| By: | Amparo Gordillo-Tobar |
| Keywords: | Early Child and Children's Health Health, Nutrition and Population - Adolescent Health Health Monitoring and Evaluation Health Systems Development and Reform Gender - Gender and Health Health Nutrition and Population |
| Date: | 2012–06 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:12418&r=hea |
| By: | Zeynep Önder |
| Keywords: | Health, Nutrition and Population - Tobacco Use and Control Health, Nutrition and Population - Alcohol and Substance Abuse Health, Nutrition and Population - Adolescent Health Tertiary Education Secondary Education Education Health Nutrition and Population |
| Date: | 2012–01 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:13032&r=hea |
| By: | Roberto Iunes; Leonardo Cubillos-Turriago; Maria-Luisa Escobar |
| Keywords: | Law and Development - Health Law Health, Nutrition and Population - Health Economics & Finance Health, Nutrition and Population - Health Monitoring & Evaluation Health, Nutrition and Population - Health Systems Development & Reform Communities and Human Settlements - Housing & Human Habitats |
| Date: | 2012–07 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:13072&r=hea |
| By: | World Bank |
| Keywords: | Law and Development - Health Law Health Economics and Finance Health Monitoring and Evaluation Health Systems Development and Reform Finance and Financial Sector Development - Access to Finance Health Nutrition and Population |
| Date: | 2012–12 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:13211&r=hea |
| By: | World Bank |
| Date: | 2012–01 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:2729&r=hea |