We study the drivers of geographic variation in U.S. health care utilization, using an empirical strategy that exploits migration of Medicare patients to separate the role of demand and supply factors. Our approach allows us to account for demand differences driven by both observable and unobservable patient characteristics. Within our sample of over-65 Medicare beneficiaries, we find that 40–5...

To investigate barriers to universal health insurance in developing countries, we designed a randomized experiment involving about 6,000 households Indonesia who are subject government program with weakly enforced mandate. Time-limited subsidies increased enrollment and attracted lower-cost enrollees, part by reducing the strategic timing of correspond needs. Registration assistance also enroll...

The Omnibus Budget Reconciliation Act of 1990 introduced a refundable tax credit for low-income working families who purchased health insurance coverage for their children. This health insurance tax credit (HITC) existed during tax years 1991, 1992, and 1993, and was then rescinded. We use Current Population Survey data and a difference-in-differences approach to estimate the HITC’s effect on p...

Using data covering over 100 birth-cohorts in 32 countries, we examine the shortand long-term effects of economic conditions on mortality. We find that small, but not large, booms increase contemporary mortality. Yet booms from birth to age 25, particularly those during adolescence, lower adult mortality. A simple model can rationalize these findings if economic conditions differentially affect...

This paper estimates the long-run effects of childhood Medicaid eligibility on adult health and economic outcomes using program’s original introduction ( 1966–1970) its mandated coverage welfare recipients. The design compares cohorts born in different years relative to implementation, states with preexisting welfare-based eligibility. Early reduces mortality disability, increases employment, r...

We study the effect of privatizing Medicaid drug benefits on prices and utilization. Drug spending would decrease by 21.3 percent if private insurers administered all benefits. One-third is driven insurers’ ability to negotiate with pharmacies. The remaining two-thirds greater use lower cost drugs, such as generics, only realized in states that give flexibility design Privatization does not red...

We examine the proposal by Peter Zweifel and Michael Breuer to combine risk-based premiums with a subsidy for individuals whose expenditure for health insurance exceeds a certain share of income. Assuming a maximin social welfare function and optimal linear income taxation, we find that this proposal is superior to social insurance if the correlation between productivity and health is not too l...

We explore how private drug plans set cost-sharing in the context of Medicare Part D. While publicly-provided drug coverage typically involves uniform cost-sharing across drugs, we document substantial heterogeneity in the cost-sharing for different drugs within privately-provided plans. We also document that private plans systematically set higher consumer cost sharing for drugs or classes ass...

We evaluate whether hospital adoption of electronic medical records (EMRs) leads to increases in billing where financial gains are large or where hassle costs of complete coding are low. The 2007 Medicare payment reform varied both financial incentives and hassle costs of coding. We find no significant impact of financial incentives on billing levels, inconsistent with bill inflation. However, ...

Measuring the output and productivity of the health care sector is important but difficult, and it has been a long-standing policy concern. Statistical agencies in some countries such as U.K., Eurostat, Australia, and the U.S. have done substantial research to investigate various approaches to measure the output. This paper reviews recent developments in the economic measurement of health care ...