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on Health Economics |
| By: | Paul J. Eliason; Riley J. League; Jetson Leder-Luis; Ryan C. McDevitt; James W. Roberts |
| Abstract: | We study the relative effectiveness of administrative regulations, criminal enforcement, and civil lawsuits for combatting health care fraud. Between 2003 and 2017, Medicare spent $7.7 billion on 37.5 million regularly scheduled, non-emergency ambulance rides for patients traveling to and from dialysis facilities, with dozens of lawsuits alleging that Medicare reimbursed rides for patients who did not meet the requirements for receiving one. Using a novel data set and an identification strategy based on the staggered timing of regulations and lawsuits across the United States, we find that a regulation requiring prior authorization for ambulance reimbursements reduced spending much more than criminal and civil lawsuits did. Despite the sharp drop in both ambulance transports and the companies that provide them following prior authorization, patients’ health outcomes did not change, indicating that most rides were not medically necessary. Our results suggest that administrative actions have a much larger impact than targeted criminal enforcement, providing novel evidence that regulations may be more cost-effective than ex post ligation for preventing health care fraud. |
| JEL: | D22 D73 H41 I18 K42 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:29491&r= |
| By: | Vegard M. Nygaard; Gajendran Raveendranathan |
| Abstract: | The introduction of employer-sponsored insurance (ESI) in the 1940s led to the largest decline in the uninsurance rate in U.S. history. To study the fiscal and welfare implications of this insurance expansion, we endogenize the selection of workers into jobs with and without ESI in a general equilibrium life-cycle model where consumers face idiosyncratic health shocks. Our model rationalizes non-targeted empirical patterns related to ESI coverage between 1940 and 2010 and in recent cross-sectional data. ESI leads to moderate welfare gains in the short run (0.5 percent of lifetime consumption for the average consumer) but zero gains or even moderate losses in the long run. The reason is that the health insurance benefit provided by ESI dominates in the short run but the tax increase required to offset ESI tax exemptions dominates in the long run. We substantiate these welfare estimates by showing that our model rationalizes both the level and rise in total ESI tax exemptions. Finally, we show that tax-financed universal health insurance — considered among policymakers in the 1930s — would have led to significantly higher welfare gains. |
| Keywords: | employer-sponsored insurance; general equilibrium life-cycle; heterogeneous agents; universal health-care insurance; welfare. |
| JEL: | E24 H51 I13 J33 |
| Date: | 2021–12 |
| URL: | http://d.repec.org/n?u=RePEc:mcm:deptwp:2021-11&r= |
| By: | M. Kate Bundorf; Daniel P. Kessler |
| Abstract: | Although economic theory suggests that the federal government can influence spending by states through subsidies to programs that states operate, no recent work has quantified the magnitude of this effect for Medicaid, the largest program of this type in the U.S. We find that Medicaid spending per enrollee responds to the magnitude of the federal subsidy. The Affordable Care Act (ACA) and its subsequent interpretation by the Supreme Court gave states the option to expand eligibility for their Medicaid programs in exchange for increases in the generosity of the federal subsidy. States that exercised this option increased Medicaid spending per enrollee on enrollees who were eligible even before the ACA by approximately 15 percent. Depending on the specification, this translates into an elasticity of Medicaid spending per enrollee with respect to the after-subsidy price of Medicaid to a state of -0.494 to -0.579. |
| JEL: | H11 H71 H72 H75 H77 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:29492&r= |
| By: | Griebenow, Malte; Kifmann, Mathias |
| Abstract: | This paper analyzes the referral processes between a gatekeeping primary-care physician (PCP) and a specialist. Specialists provide superior treatment for some patients but are more costly than PCPs. Agency problems arise because diagnostic signals are private information of the physicians. Welfare optimizing contracts can call for a markup either to the PCP for treatingpatients without referral or to the specialist for referring patients back to the PCP. If the benefit of specialist treatment is uncertain, small markups for the specialist enhance welfare compared to a cost-based fee-for-service contract. Additionally, we consider how waiting costs for referrals affect our main results. |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:hcherp:202125&r= |
| By: | Martin Hackmann (UCLA, NBER, and CESifo); Joerg Heining (Institut für Arbeitsmarkt-und Berufsforschung (IAB)); Roman Klimke (Harvard University); Maria Polyakova (Stanford University, NBER and CESifo); Holger Seibert (Institut für Arbeitsmarkt-und Berufsforschung (IAB)) |
| Abstract: | Arrow (1963) hypothesized that demand-side moral hazard induced by health insurance leads to supply-side expansions in healthcare markets. Capturing these effects empirically has been challenging, as non-marginal insurance expansions are rare and detailed data on healthcare labor and capital is sparse. We combine administrative labor market data with the geographic variation in the rollout of a universal insurance program—the introduction of long-term care (LTC) insurance in Germany in 1995—to document a substantial expansion of the inpatient LTC labor market in response to insurance expansion. A 10 percentage point expansion in the share of insured elderly leads to 0.05 (7%) more inpatient LTC firms and four (13%) more workers per 1,000 elderly in Germany. Wages did not rise, but the quality of newly hired workers declined. We find suggestive evidence of a reduction in old-age mortality. Using a machine learning algorithm, we characterize counterfactual labor market biographies of potential inpatient LTC hires, finding that the reform moved workers into LTC jobs from unemployment and out of the labor force rather than from other sectors of the economy. We estimate that employing these additional workers in LTC is socially efficient if patients value the care provided by these workers at least at 25% of the market price for care. We show conceptually that, in the spirit of Harberger (1971), in a second-best equilibrium in which supply-side labor markets do not clear at perfectly competitive wages, subsidies for healthcare consumption along with the associated demand-side moral hazard can be welfare-enhancing. |
| Keywords: | long-term care, universal insurance expansion, Germany, LTC labor market, second-best efficiency |
| JEL: | D61 I11 I13 J21 J23 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:upj:weupjo:21-357&r= |
| By: | Piriu, Andreea Alexandra |
| Abstract: | As the COVID-19 pandemic unfolds, future health care expenditure is likely the discriminant between nations who will build resilience and those who will not. Despite costly labor-market adjustments due to increased international trade over the last two decades, the health effects of trade liberalization are underexplored, with potentially wide implications for public policy and national budgets. Given the remarkable increase in trade volumes between Germany and China following reunification, this paper studies the causal effects of Chinese import competition on the health outcomes of individuals working in the German manufacturing sector. Results in this reduced-form approach exploiting region-industry variation in imports over 22 years show that higher import competition from China increases the individual demand for healthcare and probability of developing chronic illness via job insecurity, job loss and occupational change, an increased reliance on social welfare, and wage reduction. I find that individuals increase their visits to the doctor by 14 per cent and are 18.4 to 20.6 per cent more likely to develop chronic illness, on average. Results are robust for alternative health outcomes and across different population subgroups. The paper calls for reshaping health policy such that it governs well-being, starting with prevention and adequate care for working individuals: amidst globalization and recent chronic disease management, it is fundamental that future sustainable health policy champions the idea that creating better jobs means avoiding preventable costs of care from increased healthcare utilization and hence more effective chronic care through the introduction of preventive primary care plans for vulnerable working population segments. |
| Keywords: | trade,labor,job insecurity,individual health,chronic illness,healthcare utilization |
| JEL: | F14 F16 I12 I15 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:992&r= |
| By: | Vadean, Florin; Saloniki, Eirini |
| Abstract: | Staff turnover in the long-term care (LTC) sector in England is perceived to be relatively high. Most job leavers do not leave the sector, but rather move to other LTC employers. Nevertheless, there are concerns that the high 'churn' has a negative impact on continuity and quality of care, care providers' recruitment and training costs, and the remaining staff workload and motivation. Using a large employer-employee panel dataset, this study aimed to provide quantitative evidence on the drivers of LTC staff retention and sick leave in England, with a focus on job quality. After controlling for observed individual, organisational and local market characteristics as well as unobserved worker and employer heterogeneity, we found that, everything else being equal, wages and employment conditions (i.e. full time contracts and contracts with guaranteed working hours) significantly improve staff retention. The wage effect was significantly underestimated when not controlling for unobserved heterogeneity. Our findings show that improving pay and employment conditions for care staff employed by independent providers would reduce the staff turnover in LTC. We also found that, everything else being equal, the amount of sick leave was strongly associated with employment in publicly owned care establishments, most likely due to the relatively more generous sick leave terms they offer. |
| Keywords: | job separation,long-term care,job quality,sick leave,England |
| JEL: | C23 J31 J63 J81 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:994&r= |
| By: | Mr. David Stenzel; Rasmane Ouedraogo |
| Abstract: | The COVID-19 pandemic and lockdowns have led to a rise in gender-based violence. In this paper, we explore the economic consequences of violence against women in sub-Saharan Africa using large demographic and health survey data collected pre-pandemic. Relying on a two-stage least square method to address endogeneity, we find that an increase in the share of women subject to violence by 1 percentage point can reduce economic activities (as proxied by nightlights) by up to 8 percent. This economic cost results from a significant drop in female employment. Our results also show that violence against women is more detrimental to economic development in countries without protective laws against domestic violence, in natural resource rich countries, in countries where women are deprived of decision-making power and during economic downturns. Beyond the moral imperative, the findings highlight the importance of combating violence against women from an economic standpoint, particularly by reinforcing laws against domestic violence and strengthening women’s decision-making power. |
| Keywords: | Gender-based violence, economic development, sub-Saharan Africa |
| Date: | 2021–11–19 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfwpa:2021/277&r= |
| By: | Bindler, Anna (University of Colonge); Hjalmarsson, Randi (Department of Economics, School of Business, Economics and Law, Göteborg University); Ketel, Nadine (Vrije Universiteit Amsterdam); Mitrut, Andreea (Department of Economics, School of Business, Economics and Law, Göteborg University) |
| Abstract: | Many rights are conferred on Dutch youth at ages 16 and 18. Using national register data for all reported victimizations, we find sharp and discontinuous increases in victimization rates at these ages: about 13% for both genders at 16 and 9% (15%) for males (females) at 18. These results are comparable across subsamples (based on socio-economic and neighborhood characteristics) with different baseline victimization risks. We assess potential mechanisms using data on offense location, cross-cohort variation in the minimum legal drinking age driven by a 2014 reform, and survey data of alcohol/drug consumption and mobility behaviors. We conclude that the bundle of access to weak alcohol, bars/clubs and smoking increases victimization at 16 and that age 18 rights (hard alcohol, marijuana coffee shops) exacerbate this risk; vehicle access does not play an important role. Finally, we do not find systematic spillover effects onto individuals who have not yet received these rights. |
| Keywords: | victimization; crime; youth; youth protection laws; alcohol; inequality; RDD |
| JEL: | I12 I14 J13 K36 K42 |
| Date: | 2021–12 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:gunwpe:0817&r= |
| By: | Robert Kaestner; Ofer Malamud |
| Abstract: | The authors use data from the Children of the National Longitudinal Survey of Youth (C-NLSY79) to examine gender differences in the associations between child behavioral problems and early adult earnings. They find large and significant earnings penalties for women who exhibited more headstrong behavior and for men who exhibited more dependent behavior as children. In contrast, there are no penalties for men who were headstrong or for women who were dependent. While other child behavioral problems are also associated with labor market earnings, their associations are not significantly different by gender. The gender differences in headstrong and dependent behavior are not explained by education, marriage, depression, self-esteem, health, or adult personality traits. However, one potential explanation is that these gender differences are a consequence of deviations from gender norms and stereotypes in the workplace. |
| JEL: | J16 J24 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:29509&r= |
| By: | Tepe, Johanna; Lemken, Dominic |
| Abstract: | The growing prevalence of ultra-processed foods in Uganda is driving the double burden of malnutrition. Overweight and obesity are on the rise while the intake of micronutrients remains insufficient. Simultaneously, jackfruits that are rich in minerals and vitamins remain underutilized. Its large size, sticky insides, and high perishability make it challenging to handle and cause high postharvest losses. In an attempt to address both issues, the present study investigates the potential of long-lasting, nutritious, and sugar-free jackfruit-nut-bars (JNBs) as a channel to enhance and promote the utilization of jackfruit, and provide healthier options of processed foods. To analyze consumer demand for the products, we first assess the sensory perception of four different JNBs at a university campus in Uganda. We then use Van Westendorp’s price sensitivity meter to elicit consumers’ willingness to pay (WTP) and identify factors shaping their demand. The results show that the sensory properties are, on average, rated positively, and price preferences are similar to established snacks. Based on our findings, we conclude that JNBs provide an option to enhance jackfruit utilization. A random effects model shows that WTP increases with sweetness, age, and frequency of snack consumption that JNBs can potentially substitute. These findings help future development and promotion of processed jackfruit products. |
| Keywords: | Community/Rural/Urban Development, Demand and Price Analysis, Food Consumption/Nutrition/Food Safety, Marketing |
| Date: | 2021–12–15 |
| URL: | http://d.repec.org/n?u=RePEc:ags:gagkfc:316519&r= |
| By: | Mst Asma Khatun (School of Economics and Management, Kochi University of Technology); Koji Kotani (School of Economics and Management, Kochi University of Technology) |
| Abstract: | Food intake inequality at individual level is rarely analyzed in intrahousehold settings. We examine dietary diversity scores of household members with a focus on their family roles (fathers, mothers, sons, daughters and grandparents) and age groups (children, adults and elderly). Whereas theory suggests that members in a household should have equal dietary diversity by receiving a certain share of available foods, this research hypothesizes that they do not do so by their roles and/or age groups. We conduct questionnaire surveys, collecting sociodemographic information and dietary data using a 24-hour recall method of 3248 subjects in 811 households from one urban and two rural areas in Bangladesh. The statistical analysis demonstrates three findings. First, poor and rural people have lower dietary diversity than non-poor and urban people, respectively. Second, grandparents (children) have lower dietary diversity than do fathers (adults), confirming an existence of intrahousehold food intake inequality by the roles and/or age groups, irrespective of poverty level and areas of residence. Third, father and mother educations are crucial determinants to uniformly raise the standard of dietary diversity for their household, however, they do not resolve the inequality. Overall, it is suggested that awareness programs of dietary diversity shall be necessary with a target group of fathers and mothers for the betterment of intrahousehold inequality and health at household level, contributing to SDGs. |
| Keywords: | Dietary diversity, Family role, Age, Intrahousehold inequality, Bangladesh |
| Date: | 2021–12 |
| URL: | http://d.repec.org/n?u=RePEc:kch:wpaper:sdes-2021-15&r= |
| By: | Carlsson, Fredrik (Department of Economics, School of Business, Economics and Law, Göteborg University); Kataria, Mitesh (Department of Economics, School of Business, Economics and Law, Göteborg University); Lampi, Elina (Department of Economics, School of Business, Economics and Law, Göteborg University) |
| Abstract: | Using a stated preference survey, we investigate whether the introduction of a set of food labels affects consumers´ willingness to make costly shifts from meat products to meat substitutes. We investigate the role of food labels relating to health, use of antibiotics, climate impact, and animal care. We find that climate and healthiness labeling of substitutes increases the likelihood that consumers will switch to such products. We also find that labeling of the meat option can play an important role when choosing a food product. Labels concerning animal care, antibiotics use, and healthiness are all important for consumers’ choices, while a climate impact label placed on meat plays a smaller role. If meat is produced with severe restrictions on antibiotics use and the producers guarantee a high level of animal care, consumers will generally, all else equal, prefer the meat alternative. Twenty-five percent of the respondents are not willing to choose anything other than meat in the experiment. This subset of consumers are probably very difficult to influence. We find, however, that making a meat substitute taste more like meat is a key factor for those with limited experience of consuming soy products. |
| Keywords: | meat substitutes; stated preferences; labels |
| JEL: | Q18 Q51 |
| Date: | 2021–12 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:gunwpe:0816&r= |
| By: | Jens Robben; Katrien Antonio; Sander Devriendt |
| Abstract: | We aim to assess the impact of a pandemic data point on the calibration of a stochastic multi-population mortality projection model and its resulting projections for future mortality rates. Throughout the paper we put focus on the Li & Lee mortality model, which has become a standard for projecting mortality in Belgium and the Netherlands. We calibrate this mortality model on annual deaths and exposures at the level of individual ages. This type of mortality data is typically collected, produced and reported with a significant delay of -- for some countries -- several years on a platform such as the Human Mortality Database. To enable a timely evaluation of the impact of a pandemic data point we have to rely on other data sources (e.g. the Short-Term Mortality Fluctuations Data series) that swiftly publish weekly mortality data collected in age buckets. To be compliant with the design and calibration strategy of the Li & Lee model, we have to transform the weekly mortality data collected in age buckets to yearly, age-specific observations. Therefore, our paper constructs a protocol to ungroup the deaths and exposures registered in age buckets to individual ages. To evaluate the impact of a pandemic shock, like COVID-19 in the year 2020, we weigh this data point in either the calibration or projection step. Obviously, the more weight we place on this data point, the more impact we observe on future estimated mortality rates and life expectancies. Our paper allows to quantify this impact and provides actuaries and actuarial associations with a framework to generate scenarios of future mortality under various assessments of the pandemic data point. |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2111.10164&r= |
| By: | Christopher J. Ruhm |
| Abstract: | Accurately determining the number of excess deaths caused by the COVID-19 pandemic is hard. The most important challenge is accurately estimating the counterfactual count of baseline deaths that would have occurred in its absence. This analysis used new methods to: estimate this baseline metric; calculate excess deaths during the first year of the U.S. COVID-19 pandemic; and examine plausibility of the excess death estimates obtained in this and prior analyses. Total, group-specific and cause-specific excess deaths in the U.S. from March 2020 through February 2021 were calculated using publicly available data covering all deaths from March 2009 through December 2019 and provisional data from January 2020 through February 2021. The estimates indicate that there were 646,514 (95% CI: 597,514 to 695,520) excess deaths in the U.S. during this period, with 83.4% (95% CI: 77.5% - 90.2%) of these attributed directly to COVID-19. There were substantial differences across population groups and causes in the ratio of actual-to-baseline deaths, and in the contribution of COVID-19 to excess mortality. Prior research has frequently underestimated baseline deaths and so has overstated excess mortality and the percentage of it attributed to non-COVID-19 causes. |
| JEL: | I10 I13 I18 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:29503&r= |
| By: | Ms. TengTeng Xu; Mr. Pragyan Deb |
| Abstract: | The health and economic impacts of COVID-19 on India have been substantial, with wide variation across states and union territories. This paper quantifies the impact of containment measures and voluntary social distancing on both the spread of the virus and the economy at the state level during the first wave of the COVID-19 pandemic. We construct a de-facto measure of state-level social distancing, combining containment strigency and observed mobility trends. State-level empirical analysis suggests that social distancing and containment measures effectively reduced case numbers, but came with high economic costs. State characteristics, such as health care infrastructure and the share of services in the economy, played an important role in shaping the health and economic outcomes, highlighting the importance of adequate social spending, health care infrastructure, and social safety nets. |
| Keywords: | India; COVID-19; social distancing; containment measures. |
| Date: | 2021–11–19 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfwpa:2021/279&r= |
| By: | Michael Becher; Nicolas Longuet Marx; Vincent Pons; Sylvain Brouard; Martial Foucault; Vincenzo Galasso; Eric Kerrouche; Sandra León Alfonso; Daniel Stegmueller |
| Abstract: | Beyond its immediate impact on public health and the economy, the COVID-19 pandemic has put democracy under stress. While a common view is that people should blame the government rather than the political system for bad crisis management, an opposing view is that dissatisfaction with government performance may cause deeper dissatisfaction with democracy even in consolidated democratic regimes. We use a pre-registered survey and experiment covering 12 countries and 22,500 respondents to examine the impact of the pandemic on public attitudes about incumbent governments, the functioning of democracy and support for different types of regimes. To estimate causal effects, we leverage experimental treatments using an instrumental variable design. We find that dissatisfaction with the government, which is equally driven by economic and health considerations, decreases satisfaction with how democracy works. However, it does not translate into an embrace of non-democratic regime types. |
| JEL: | D72 D83 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:29514&r= |
| By: | Joshua Aizenman; Alex Cukierman; Yothin Jinjarak; Weining Xin |
| Abstract: | Recent observations on countries like the UK that have accumulated a large fraction of inoculated individuals suggest that, although initially, vaccines have little effect on new infections they strongly reduce the share of mortality out of a given pool of infections. This paper examines the extent to which this phenomenon is more general by testing the hypothesis that the ratio of current mortality to lagged infections is decreasing in the total number of vaccines per one hundred individuals. This is done in a pooled time-series, cross-section sample with weekly observations for up to 208 countries. The main conclusion from the statistical analysis is that, passed a certain threshold, vaccines moderate the share of mortality from a given pool of lagged infections. This is essentially a favorable shift in the tradeoff between life preservation and economic performance. Controlling for income per capita, stringency of containment measures, and the fraction of recovered and old individuals, estimation is carried out by linear least squares, with standard errors clustered by country and region. The main result is robust to sensitivity analysis with a logarithmic specification. The practical lesson is that, in the presence of a sufficiently high share of inoculated individuals, governments can shade down containment measures, even as infections are still rampant, without significant adverse effects on mortality. |
| JEL: | F42 F44 I18 |
| Date: | 2021–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:29498&r= |
| By: | Tahsin Saadi Sedik |
| Abstract: | COVID-19 has exacerbated concerns about the rise of the robots and other automation technologies. This paper analyzes empirically the impact of past major pandemics on robot adoption and inequality. First, we find that pandemic events accelerate robot adoption, especially when the health impact is severe and is associated with a significant economic downturn. Second, while robots may raise productivity, they could also increase inequality by displacing low-skilled workers. We find that following a pandemic, the increase in inequality over the medium term is larger for economies with higher robot density and where new robot adoption has increased more. Our results suggest that the concerns about the rise of the robots amid the COVID-19 pandemic seem justified. |
| Keywords: | Pandemics;Robots;Inequality.;WP;pandemic event;studies showing;impact of pandemic;country-industry pair level;industry breakdown |
| Date: | 2021–01–15 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfwpa:2021/011&r= |
| By: | Mr. Serhan Cevik; Fedor Miryugin |
| Abstract: | The global economy is in the midst of an unprecedented slump caused by the COVID-19 pandemic. To assess the likely evolution of nonfinancial corporate performance going forward, this paper investigates empirically the impact of past pandemics using firm-level data on more than 537,000 companies from 14 developing countries during the period 1998–2018. The analysis indicates that the prevalence of infectious diseases has an economically and statistically significant negative effect on nonfinancial corporate performance. This adverse impact is particularly pronounced on smaller and younger firms, compared to larger and more established corporations. We also find that a higher number of infectious-disease cases in population increases the probability of failure among nonfinancial firms, particularly for small and young firms. In the case of COVID-19, the magnitude of these effects will be much greater, given the unprecedented scale of the outbreak and strict policy responses to contain its spread. |
| Keywords: | Pandemics;nonfinancial corporate performance;firm-level;WP;nonfinancial firm;firm level;liquidity pressure;sector peer;firm performance;revenue base |
| Date: | 2020–12–11 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfwpa:2020/276&r= |
| By: | Philippe De Donder; Humberto Llavador; Stefan Penczynski; John E. Roemer; Roberto Vélez |
| Abstract: | Whether or not to vaccinate one's child is a decision that a parent may approach in several ways. The vaccination game, in which parents must choose whether to vaccinate a child against a disease, is one with positive externalities (herd immunity). In some societies, not vaccinating is an increasingly prevalent behavior, due to deleterious side effects that parents believe may accompany vaccination. The standard game-theoretic approach assumes that parents make decisions according to the Nash behavioral protocol, which is individualistic and non-cooperative. Because of the positive externality that each child's vaccination generates for others, the Nash equilibrium suffers from a free-rider problem. However, in more solidaristic societies, parents may behave cooperatively -they may optimize according to the Kantian protocol, in which the equilibrium is efficient. We test, on a sample of six countries, whether childhood vaccination behavior conforms better to the individualistic or cooperative protocol. In order to do so, we conduct surveys of parents in these countries, to ascertain the distribution of beliefs concerning the subjective probability and severity of deleterious side effects of vaccination. We show that in all the countries of our sample the Kant model dominates the Nash model. We conjecture that, due to the free-rider problem inherent in the Nash equilibrium, a social norm has evolved, quite generally, inducing parents to vaccinate with higher probability than they would in the non-cooperative solution. Kantian equilibrium offers one precise version of such a social norm. |
| Keywords: | Kantian equilibrium, Nash equilibrium, vaccination, social norm |
| JEL: | C72 D62 D63 I12 |
| Date: | 2021–12 |
| URL: | http://d.repec.org/n?u=RePEc:upf:upfgen:1808&r= |
| By: | Mr. Alexander D Klemm; Mr. Paolo Mauro |
| Abstract: | Based on a survey of about 2,500 US resident adults, we show that people who have experienced serious illness or job loss caused by the COVID-19 pandemic, or who personally know someone who has, favor a temporary progressive levy or structural progressive tax reform to a greater extent than others in the sample, controlling for income, demographic characteristics, and other factors. People who reveal preferences for spending items (more on police, military, border protection; less on education, health, environment) that are associated with communitarian (rather than universalist) moral perspectives generally show weaker support for progressive reforms, but more communitarians change their views as a result of personal experience. The results are consistent with previous findings that economic upheavals can mold individuals’ views on policy matters. |
| Keywords: | Solidarity taxes;surcharges;surveys;attitudes;progressivity;tax reform.;WP;solidarity contribution;solidarity tax;recovery contribution;household income;income level |
| Date: | 2021–02–05 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfwpa:2021/024&r= |