nep-hea New Economics Papers
on Health Economics
Issue of 2024‒06‒17
twenty-one papers chosen by
Nicolas R. Ziebarth, Cornell University


  1. Designing Dynamic Reassignment Mechanisms: Evidence from GP Allocation By Ingrid Huitfeldt; Victoria Marone; Daniel C. Waldinger
  2. Do E-Cigarette Retail Licensure Laws Reduce Tobacco Use? By Charles J. Courtemanche; Yang Liang; Johanna Catherine Maclean; Caterina Muratori; Joseph J. Sabia
  3. Demand For E-Cigarettes Based On Nicotine Strength: Evidence From Retail Sales By Megan C. Diaz; Adrian Bertrand; Tatum McKay; Barbara A. Schillo; Bushraa S. Khatib; John A. Tauras
  4. Alleviating Worker Shortages Through Targeted Subsidies: Evidence from Incentive Payments in Healthcare By Ashvin Gandhi; Andrew Olenski; Krista J. Ruffini; Karen Shen
  5. The Design of Insurance Contracts for Home versus Nursing Home Long-Term Care By Borsenberger, Claire; Cremer, Helmuth; Joram, Denis; Lozachmeur, Jean-Marie; Malavolti, Estelle
  6. Pricing Innovation in Surgical Care Markets By Alice Chen; Seth M. Freedman; Elizabeth L. Munnich; Michael R. Richards
  7. Interest Groups, Ideology, and Indirect Lobbying: The Rise of Private Health Insurance In the United States By Marcella Alsan; Yousra Neberai; Xingyou Ye
  8. Conceiving Naturally After IVF: the effect of assisted reproduction on obstetric interventions and child health at birth By Fabio I. Martinenghi; Xian Zhang; Luk Rombauts; Georgina M. Chambers
  9. The Economics of Infertility: Evidence from Reproductive Medicine By Sarah Bögl; Jasmin Moshfegh; Petra Persson; Maria Polyakova
  10. The Effects of Mental Health Interventions on Labor Market Outcomes in Low- and Middle-Income Countries By Crick Lund; Kate Orkin; Marc Witte; John H. Walker; Thandi Davies; Johannes Haushofer; Sarah Murray; Judy Bass; Laura Murray; Wietse Tol; Vikram H. Patel
  11. The Causal Effect of Repealing Certificate-of-Need Laws for Ambulatory Surgical Centers: Does Access to Medical Services Increase? By Thomas Stratmann; Markus Bjoerkheim; Christopher Koopman
  12. Pharmacy Access and Health-seeking Behavior: Evidence from a Nationwide Policy By Singh, Tejendra Pratap
  13. Defining the Key Predictors of Losses in Healthy Years of Life: A Cross-Country Investigation By Kyselova, Vladyslava; Popovych, Tetiana; Buryhina, Khrystyna; Topchii, Sofiia
  14. Forced Displacement, Mental Health, and Child Development: Evidence from the Rohingya Refugees By Islam, Asad; Mozumder, Tanvir Ahmed; Rahman, Tabassum; Shatil, Tanvir; Siddique, Abu
  15. Identifying and Mitigating the Public Health Consequences of Meta-Ignorance about "Long COVID" Risks By Motta, Matt; Callaghan, Timothy; Ross, Jennifer; Padmanabhan, Medini; Gargano, Lisa; Bowman, Sarah; Yokum, David Vincent
  16. Transition to motherhood: The role of health By Simankova, Irina; Tauchmann, Harald
  17. Women’s job market outcomes around live and non-live births By Di Nallo, Alessandro
  18. Is Baumol's Cost Disease Really a Disease? Healthcare Expenditure and Factor Reallocation By Rude, Johanna; Weber, Lukas
  19. Natural disasters and the demand for health insurance By Ha Trong Nguyen; Mitrou, Francis
  20. COVID-19 Risk Perceptions in Japan: A Cross Sectional Study By Asako Chiba; Taisuke Nakata; Thuy Linh Nguyen; Reo Takaku
  21. Optimal Vaccine Allocation Strategy: Theory and Application to the Early Stage of COVID-19 in Japan By Toshikazu Kuniya; Taisuke Nakata; Daisuke Fujii

  1. By: Ingrid Huitfeldt; Victoria Marone; Daniel C. Waldinger
    Abstract: Many centralized assignment systems seek to not only provide good matches for participants’ current needs, but also to accommodate changes in preferences and circumstances. We study the problem of designing a dynamic reassignment mechanism in the context of Norway’s system for allocating patients to general practitioners (GPs). We provide direct evidence of misallocation under the current system––patients sitting on waitlists for each others’ GPs, but who cannot trade––and analyze an alternative mechanism that adapts the Top-Trading Cycles (TTC) algorithm to a dynamic environment. In contrast to the static case, dynamic TTC may leave some agents worse off relative to a status quo where trades are not permitted, introducing novel concerns about fairness. We empirically evaluate how this mechanism would perform by estimating a structural model of switching behavior and GP choice. While introducing TTC would on average reduce waiting times and increase patient welfare––with especially large benefits for female patients and recent movers––patients endowed with undesirable GPs would be harmed. Adjustments to the priority system can avoid harming this group while preserving most of the gains from TTC.
    JEL: D04 D47 I18
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32458&r=
  2. By: Charles J. Courtemanche; Yang Liang; Johanna Catherine Maclean; Caterina Muratori; Joseph J. Sabia
    Abstract: E-cigarette licensure laws (ELLs) require retailers to obtain a state license to sell e-cigarettes over the counter. This study is the first to comprehensively explore the effect of ELL adoption on youth and adult tobacco product use. Using data from the State Youth Risk Behavior Survey (YRBS) and a difference-in-differences approach, we find no evidence that ELL adoption reduces overall youth ENDS use. The precision of our estimates allows us to rule out, with 95 percent confidence, ELL-induced prior-month youth ENDS use declines of more than 3.4 percent. The pattern of null findings persists when we examine ELLs that impose (1) higher penalties for retailer non-compliance, (2) higher renewable licensure fees, and (3) criminal as compared to civil penalties. However, we do uncover evidence that adoption of ELLs with higher penalties associated with a modest reduction in ENDS use among Black teens. We conclude that ELLs have only limited success in curbing access to ENDS.
    JEL: I10 I12 I18
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32444&r=
  3. By: Megan C. Diaz; Adrian Bertrand; Tatum McKay; Barbara A. Schillo; Bushraa S. Khatib; John A. Tauras
    Abstract: Using NielsenIQ Retail Scanner data, we estimate demand equations for e-cigarettes by nicotine concentration. Overall, the models show that the price elasticities of demand range from -2.117 to -1.494. In a rapidly evolving e-cigarette market, demand for e-cigarettes varies considerably by nicotine strength. High-nicotine products, which have many close substitutes, are found to be more responsive to changes in price. Demand for low-nicotine products, with few close substitutes, are found to be less responsive to changes in price. Our findings also suggest that e-cigarettes with the lowest and highest nicotine concentrations may be economic complements, suggesting concurrent use. Unlike available evidence on cross-tax elasticities of demand, we find no evidence of an economic relationship between traditional cigarettes and e-cigarettes when broken down by nicotine strength concentration.
    JEL: I12 I18
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32435&r=
  4. By: Ashvin Gandhi; Andrew Olenski; Krista J. Ruffini; Karen Shen
    Abstract: Worker shortages are common in many industries. This paper examines the effect of government subsidies to address these shortages in the context of a reform that tied Medicaid payments to nursing home staffing levels. We find that the reform substantially increased staffing, especially for facilities serving many Medicaid patients. Facilities responded primarily by hiring workers in lower-wage roles rather than increasing hours of incumbent or high-wage staff. This contrasts with null effects we estimate for a non-incentivized rate increase, suggesting that the incentive structure of government payments—rather than just the level—is key to boosting employment in sectors facing worker shortages.
    JEL: I10 I18 J23
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32412&r=
  5. By: Borsenberger, Claire (Groupe La Poste); Cremer, Helmuth (Toulouse School of Economics); Joram, Denis (Groupe La Poste); Lozachmeur, Jean-Marie (Toulouse School of Economics); Malavolti, Estelle (University of Toulouse I)
    Abstract: We study the design of optimal (private and/or social) insurance schemes for formal home care and institutional care. We consider a three period model. Individuals are either in good health, lightly dependent or heavily dependent. Lightly dependent individuals can buy formal home care which reduces the severity of dependency and reduces the probability to become severely dependent in the next period. Severely dependent individuals pay for nursing home care. In both states of dependency individuals can receive a (private or public) insurance benefit (transfers). These benefits can be flat or depend on the formal care consumed (or a combination of the two). These benefits are financed by a premium (or a tax). Individuals may be alive until the end of period 2 or die at the beginning of periods 1 or 2 with a certain probability which may depend on their state of health. The laissez faire is inefficient because individuals consume a too low level of formal home care and are not insured. The first-best insurances scheme requires a transfer to lightly dependent individuals that, (under some conditions) increases with the amount of formal home care consumed. Severely dependent individuals, on the other hand, must receive a flat transfer (from private or social insurance). The theoretical analysis is illustrated by a calibrated numerical example which show that the expressions have the expected signs under plausible conditions.
    Keywords: long-term care insurance, formal home care, nursing home care
    JEL: I13 I18 H51
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp16978&r=
  6. By: Alice Chen; Seth M. Freedman; Elizabeth L. Munnich; Michael R. Richards
    Abstract: Technological innovation in medical services can improve health, but its ability to reach patients often depends on price signals for downstream providers, which can also be discordant across production inputs. We examine such a context when Medicare sharply revises facility fees—while holding physician fees constant—for advanced surgical care performed within certain outpatient settings. Industry-wide output for impacted cases increases via market expansion, and indirectly affected physicians devote more labor supply to these cases by sacrificing other outpatient and inpatient surgical volumes. Government price setting for healthcare facilities spills over onto physicians––impacting their technology utilization and time allocations.
    JEL: I11 I13 I18 L25 L84 L88
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32439&r=
  7. By: Marcella Alsan; Yousra Neberai; Xingyou Ye
    Abstract: This study examines the rise of private health insurance in the United States in the post- World War II era. We investigate the role of the American Medical Association (AMA) which financed a campaign against National Health Insurance that was directed by the country’s first political public relations firm, Whitaker & Baxter’s (WB) Campaigns, Inc. The AMA-WB Campaign had two key components: (1) physician outreach to patients and civic organizations; and (2) mass advertising that tied private insurance to “freedom” and “the American way.” We bring together archival data from several novel sources documenting Campaign intensity. We find a one standard deviation increase in Campaign exposure explains about 20% of the increase in private health insurance enrollment and a similar decline in public opinion support for legislation enacting National Health Insurance. We also find suggestive evidence that the Campaign altered the narrative for how legislators and pollsters described health insurance. These findings suggest the rise of private health insurance in the U.S. was not solely due to wartime wage freezes, collective bargaining, or favorable tax treatment. Rather, it was also enabled by an interest group-financed Campaign that used ideology to influence the behavior and views of ordinary citizens.
    JEL: D72 I14 I18 N34 N42
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32484&r=
  8. By: Fabio I. Martinenghi; Xian Zhang; Luk Rombauts; Georgina M. Chambers
    Abstract: A growing share of the world's population is being born via assisted reproductive technology (ART), including in-vitro fertilisation (IVF). However, two concerns persist. First, ART pregnancies correlate with predictors of poor outcomes at birth--and it is unclear whether this relationship is causal. Second, the emotional and financial costs associated with ART-use might exacerbate defensive medical behaviour, where physicians intervene more than necessary to reduce the risk of adverse medical outcomes and litigation. We address the challenge of identifying the pure effect of ART-use on both maternal and infant outcomes at birth by leveraging exogenous variation in the success of ART cycles. We compare the obstetric outcomes for ART-conceived births with those of spontaneously-conceived births after a failed ART treatment. Moreover, we flexibly adjust for key confounders using double machine learning. We do this using clinical registry ART data and administrative maternal and infant data from New South Wales (NSW) between 2009-2017. We find that ART slightly decreases the risk of obstetric interventions, lowering the risk of a caesarean section and increasing the rate of spontaneous labour (+3.5 p.p.). Moreover, we find that ART has a statistically and clinically insignificant effect on infant health outcomes. Keywords: Fertility, Assisted reproduction, IVF, Caesarean Section, Obstetric, Infertility. JEL classification: I10, I12, I19.
    Date: 2024–04
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2405.00234&r=
  9. By: Sarah Bögl; Jasmin Moshfegh; Petra Persson; Maria Polyakova
    Abstract: WHO estimates that as many as 1 in 6 individuals of reproductive age worldwide are affected by infertility. This paper uses rich administrative population-wide data from Sweden to construct and characterize the universe of infertility treatments, and to then quantify the private costs of infertility, the willingness to pay for infertility treatments, as well as the role of insurance coverage in alleviating infertility. Persistent infertility causes a long-run deterioration of mental health and couple stability, with no long-run “protective” effects (of having no child) on earnings. Despite the high private non-pecuniary cost of infertility, we estimate a relatively low revealed private willingness to pay for infertility treatment. The rate of IVF initiations drops by half when treatment is not covered by health insurance. The response to insurance is substantially more pronounced at lower income levels. At the median of the disposable income distribution, our estimates imply a willingness to pay of at most 22% of annual income for initiating an IVF treatment (or about a 30% chance of having a child). At least 40% of the response to insurance coverage can be explained by a liquidity effect rather than traditional moral hazard, implying that insurance provides an important consumption smoothing benefit in this context. We show that insurance coverage of infertility treatments determines both the total number of additional children and their allocation across the socioeconomic spectrum.
    JEL: H0 I0 J0
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32445&r=
  10. By: Crick Lund; Kate Orkin; Marc Witte; John H. Walker; Thandi Davies; Johannes Haushofer; Sarah Murray; Judy Bass; Laura Murray; Wietse Tol; Vikram H. Patel
    Abstract: Mental health conditions are prevalent but rarely treated in low- and middle-income countries (LMICs). Little is known about how these conditions affect economic participation. This paper shows that treating mental health conditions substantially improves recipients’ capacity to work in these contexts. First, we perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) ever conducted that evaluate treatments for mental ill-health and measure economic outcomes in LMICs. On average, treating common mental disorders like depression with psychotherapy improves an aggregate of labor market outcomes made up of employment, time spent working, capacity to work and job search by 0.16 standard deviations. Treating severe mental disorders, like schizophrenia, improves the aggregate by 0.30 standard deviations, but effects are noisily estimated. Second, we build a new dataset, pooling all available microdata from RCTs using the most common trial design: studies of psychotherapy in LMICs that treated depression and measured days participants were unable to work in the past month. We observe comparable treatment effects on mental health and work outcomes in this sub-sample of highly similar studies. We also show evidence consistent with mental health being the mechanism through which psychotherapy improves work outcomes.
    JEL: D9 I14 J24 O1
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:32423&r=
  11. By: Thomas Stratmann; Markus Bjoerkheim; Christopher Koopman
    Abstract: In many states, certificate-of-need (CON) laws prevent ambulatory surgical centers (ASCs) from entering the market or expanding their services. This paper estimates the causal effects of state ASC-CON law repeal on the accessibility of medical services statewide, as well as for rural areas. Our findings show that CON law repeals increase ASCs per capita by 44-47% statewide and 92-112% in rural areas. Repealing ASC-CON laws causes a continuous increase in ASCs per capita, an effect which levels off ten years after repeal. Contrary to the 'cream-skimming' hypothesis, we find no evidence that CON repeal is associated with hospital closures in rural areas. Rather, some regression models show that repeal is associated with fewer medical service reductions.
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2405.08160&r=
  12. By: Singh, Tejendra Pratap
    Abstract: Developing countries have wide geographical differences in access to healthcare services. While programs that aim to improve hospital-supporting institutions might improve access for large swaths of the population that cannot access healthcare, they might have an unintended consequence of substitution away from hospitals or clinics to relying on pharmacies for healthcare. Furthermore, unregulated dispensation of medicines may lead to increased incidence of antibiotic resistance in the population who rely on these pharmacies, bypassing healthcare at a hospital or clinic. In this paper, I study a nationwide program in India that improved access to pharmacies by providing cheap generic medicines. Using a difference-in-differences framework relying on geographic variation in access to these pharmacies, I find that exposed respondents are more likely to report receiving some treatment for acute ailments. This increase in healthcare-seeking behavior, however, leads to a shift away from treatment at a hospital or clinic to treatment at a pharmacy. I also find that economically and socially disadvantaged subgroups are more likely to report this substitution pattern, pointing to worsening inequality in access to quality healthcare. I reflect on potential mechanisms driving the main effect and find evidence for finance as a likely mechanism for the observed healthcare-seeking behavior in the exposed population. My main conclusions are robust to a host of empirical checks.
    Date: 2024–05–15
    URL: http://d.repec.org/n?u=RePEc:osf:osfxxx:pjvgd&r=
  13. By: Kyselova, Vladyslava; Popovych, Tetiana; Buryhina, Khrystyna; Topchii, Sofiia
    Abstract: This study identifies and analyzes the key environmental factors contributing to the loss of healthy years of life, as quantified by Disability-Adjusted Life Years (DALYs), across various regions worldwide. Using data from The Organisation for Economic Co-operation and Development (OECD) we employ an ordinary least squares (OLS) regression model to estimate the impacts of several predictors on DALYs. Our analysis indicates a positive relationship between lead exposure, air pollution, second-hand smoke, and DALYs, while the quadratic effect of air pollution negatively impacts the number of healthy life years lost. The findings show variations in the influence of these factors among different global regions, highlighting the highest level of DALY in areas with environmental issues like Africa and the smallest in well-regulated environmental regions such as Oceania. This research supports targeted public health interventions and policies aimed at mitigating environmental risks, particularly in vulnerable populations, to enhance global health outcomes.
    Keywords: Disability-Adjusted Life Years (DALYs), Cross-Country Analysis, Determinants of DALYs, Public Health Interventions
    JEL: I10 I14 I18
    Date: 2024–04–15
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:120928&r=
  14. By: Islam, Asad (Monash University); Mozumder, Tanvir Ahmed (BRAC Institute of Governance and Development); Rahman, Tabassum (University of Melbourne); Shatil, Tanvir (BRAC Institute of Governance and Development); Siddique, Abu (Royal Holloway, University of London)
    Abstract: Forced displacement is a major driver of mental health disorders among refugees globally. The mental well-being of adult refugees, particularly mothers, is widely recognized as a crucial determinant of their children's psychological health and development. In this study, we conducted a randomized controlled trial (RCT) to examine the effectiveness of a multifaceted psychosocial program in improving the mental health of refugee mothers, and fostering growth and development among children under the age of two. Collaborating with BRAC, we conducted a cluster RCT involving 3, 500 Rohingya mother-child pairs in refugee camps in Bangladesh. Participants received weekly psychosocial support for 44 weeks, facilitated by trained peer volunteers. The program included psychoeducation and parenting guidance for mothers, as well as interactive play activities for both mothers and children. The intervention proved largely successful, resulting in: (i) reductions in the psychological trauma and depression severity among both mothers and children, (ii) improvements in children's communication, gross-motor, and problem-solving skills, and (iii) reductions in the prevalence of stunting and severe stunting among children. At a cost of approximately $1 per dyad per session, the intervention has demonstrated cost-effectiveness and is currently being scaled-up in Bangladesh's refugee camps, benefiting around forty thousand mother-child dyads.
    Keywords: mental health, forced displacement, early childhood development, refugees
    JEL: I15 J15 O12 O15
    Date: 2024–04
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp16961&r=
  15. By: Motta, Matt (Boston University School of Public Health); Callaghan, Timothy; Ross, Jennifer; Padmanabhan, Medini; Gargano, Lisa; Bowman, Sarah; Yokum, David Vincent (District of Columbia Government)
    Abstract: Many efforts have been made to study both the prevalence of and public concern about "Long COVID". Fewer, however, have asked what the public knows and/or purports to know about Long COVID. This is an important oversight, as low knowledge and/or "meta-ignorance" (the Dunning Kruger Effect or DKE) concerning Long COVID might undermine public willingness to take action to protect themselves and others from endemic COVID-19. In a nationally representative survey of US adults, we find that objective levels of public knowledge about Long COVID are quite low. We also detect a prevalent DKE, such that greater than one fifth of respondents express high confidence in their perceived Long COVID knowledge, despite exhibiting lower than average objective knowledge. Unfortunately, we find that the expression of DKE -- irrespective of partisan identity -- is associated with a series of deleterious public health and health policy outcomes, including: opposition to workplace COVID-19 vaccine mandates, annual COVID-19 vaccine hesitancy, and an increased likelihood of being sick with Long COVID. We conclude by offering a data-driven discussion of both the promises and potential limitations of health communication efforts to provide the public with basic facts about the causes and consequences of Long COVID.
    Date: 2024–05–17
    URL: http://d.repec.org/n?u=RePEc:osf:socarx:hzgwm&r=
  16. By: Simankova, Irina; Tauchmann, Harald
    Abstract: The age at which women become mothers for the first time is ever increasing in many industrialized countries. Therefore, fertility determinants that might deteriorate with age, such as health, and their effect on reproductive patterns, should be given more attention. We explore the effect of the subjective general health of women of reproductive age on the conditional probability of entering motherhood. Based on estimating linear discrete-time hazard models using survey data from Germany, we do not find a homogeneous health effect on the probability of having a first child. However, allowing effect heterogeneity over the span of reproductive age reveals that the role of health is ambiguous. While good health is associated with a lower probability of entering motherhood at the beginning of the reproductive phase, the opposite holds for the late reproductive phase. This pattern is robust to employing different estimation methods (parametric, non-parametric), conditioning on socio-economic characteristics, and taking unobserved individual-level heterogeneity into account.
    Keywords: motherhood, fertility, discrete-time survival analysis, instrumental variables estimation
    JEL: C41 I19 J13
    Date: 2024
    URL: http://d.repec.org/n?u=RePEc:zbw:iwqwdp:295728&r=
  17. By: Di Nallo, Alessandro
    Abstract: This study assesses the labor market outcomes for both women who experience live births and those who undergo non-live births, in the UK. Leveraging data from the "Understanding Society" longitudinal survey spanning 2009-2023, it presents a nuanced exploration into how pregnancy outcomes—live births and non-live births—affect women's labor market trajectories, particularly in terms of labor earnings, employment probability, hourly wages, and weekly work hours. The analysis employs a step-wise approach, introducing variables related to career choices, human capital, health, and subsequent childbearing to dissect the factors influencing career paths. Findings reveal that women experiencing live births endure persistent decreases in labor earnings, highlighting a pronounced “motherhood penalty”. This penalty encompasses reduced income, diminished employment probabilities and shortened work hours. Conversely, women who face non-live births initially experience a temporary income and wage drop, which recovers, indicating a less enduring economic impact. This recovery suggests that the adverse labor market consequences of pregnancy loss, while immediate and significant, do not persist in the long term as they do with live births.
    Date: 2024–05–16
    URL: http://d.repec.org/n?u=RePEc:osf:osfxxx:2m4xb&r=
  18. By: Rude, Johanna; Weber, Lukas
    Abstract: Expenditures on healthcare and employment in the healthcare sector have been steadily increasing across OECD countries for many years. This shift of expenditure and employment towards a consistently found to be less productive sector has often been associated with the idea of Baumol’s (1967) cost disease. This paper investigates if diagnosing the healthcare sector with suffering from a cost disease is an apt description of the observed reallocation. The novel feature of the paper is to introduce a microeconomic foundation to the theoretical analysis of the healthcare sector. We show analytically in a model that the demand side is very important in determining equilibrium quantities and prices. Even if there is unequal technological progress in the two sectors, the unchanged demand of households dictates that the output level of the two sectors remains constant. This leads to the prima facie unintuitive result of factor allocation towards the less productive sector, in this case, healthcare. We show that this is the case under innocuous assumptions if goods are complements. We supplement the new theoretical results by testing implications from the model empirically. Specifically, we use household-level data to estimate the elasticity of substitution between healthcare consumption and all other consumption. We find robust evidence for the complementarity of healthcare consumption and all other consumption.
    Keywords: Healthcare Reallocation
    JEL: E20 E21 E22 E23 E24 E25 E27 I1
    Date: 2024–05–07
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:120873&r=
  19. By: Ha Trong Nguyen; Mitrou, Francis
    Abstract: Amidst growing concerns over heightened natural disaster risks, this study pioneers an inquiry into the causal impacts of cyclones on the demand for private health insurance (PHI) in Australia. We amalgamate a nationally representative longitudinal dataset with historical cyclone records, employing an individual fixed effects model to assess the impacts of various exogenously determined cyclone exposure measures. Our findings unveil that both contemporaneous and preceding cyclones, particularly those of greater severity, substantially increase the likelihood of individuals procuring PHI. The largest estimated impact amounts to over 4 percentage points, representing approximately 8% of the sample mean and aligns with documented effects of certain PHI policies aimed at enhancing coverage. Furthermore, our findings withstand a series of sensitivity assessments, including a placebo test demonstrating that future cyclones do not impact current PHI enrolment. Moreover, the cyclone impacts are more pronounced for females, younger individuals, homeowners, affluent individuals, or those with prior residential insurance coverage, as well as residents of rural and coastal areas or historically cyclone-exposed regions. Additionally, our study furnishes suggestive evidence hinting at a potential rise in risk aversion among affected individuals as a channel through which cyclones increase PHI uptake.
    Keywords: Natural Disasters, Risk Preferences, Health Insurance, Australia
    JEL: D81 G22 I13 Q54
    Date: 2024
    URL: http://d.repec.org/n?u=RePEc:zbw:glodps:1434&r=
  20. By: Asako Chiba (Tokyo Foundation for Policy Research); Taisuke Nakata (Graduate School of Economics, University of Tokyo); Thuy Linh Nguyen (Graduate School of Economics, University of Tokyo); Reo Takaku (Graduate School of Economics, Hitotsubashi University)
    Abstract: We conducted a large-scale online survey in February 2023 to investigate the perceptions of infection and fatality risks from COVID-19 in Japan. Univariate analysis comparing perceived and actual risk suggests prevalence of overestimation as well as non-negligible underestimation of COVID-19 risks in Japan. Multivariate logistic regression analysis reveals that age, income and educational levels, health status, information sources, and experiences related to COVID-19 are associated with the subjective assessments of infection and fatality risks. Given that risk perceptions are closely correlated with daily socio-economic activities and well-being, it is important for policymakers and public health experts to understand how to communicate COVID-19 risks to the public effectively.
    Date: 2024–05
    URL: http://d.repec.org/n?u=RePEc:cfi:fseres:cf583&r=
  21. By: Toshikazu Kuniya (Graduate School of System Informatics, Kobe University); Taisuke Nakata (Graduate School of Economics and Graduate School of Public Policy, University of Tokyo); Daisuke Fujii (Research Institute of Economy, Trade and Industry)
    Abstract: We construct an age-structured epidemic model to analyze the optimal vaccine allocation strategy in an epidemic. We focus on two topics: the first one is the optimal vaccination interval between the first and second doses, and the second one is the optimal vaccine allocation ratio between young and elderly people. On the first topic, we show that the optimal interval tends to become longer as the relative efficacy of the first dose to the second dose (RE) increases. On the second topic, we show that the heterogeneity in the age-dependent susceptibility (HS) affects the optimal allocation ratio between young and elderly people, whereas the heterogeneity in the contact frequency among different age groups (HC) tends to affect the effectiveness of the vaccination campaign. A counterfactual simulation suggests that the epidemic wave in the summer of 2021 in Japan could have been greatly mitigated if the optimal vaccine allocation strategy had been taken.
    Date: 2024–04
    URL: http://d.repec.org/n?u=RePEc:cfi:fseres:cf584&r=

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