October is National Breast Cancer Awareness Month. Using a 5% sample of Medicare claims data we find that October (and November) are associated with a 25% increase in the utilization of mammograms relative to the “average” month. We find that the “October” cohort is less likely to be diagnosed with breast cancer, somewhat more likely to be diagnosed with Stage 0 breast cancer conditional upon d...

In the absence of a perfect risk adjustment scheme, cost sharing can reduce risk selection in community-rated health insurance markets. However, cost sharing also reduces incentives for efficiency. In this paper, we develop a model in which insurers determine the cost efficiency of health care. They have incentives for risk selection because there are two risk types which differ in their expect...

This paper introduces a dynamic equilibrium model of the research-based pharmaceutical industry and parameterizes it using industry facts. In the model, imposing price controls in the U.S. reduces firm value, R&D, the flow of new drugs, and the net present value of consumer welfare in the U.S. and globally. Removing price controls in one or more non-U.S. countries increases firm value, R&D, the...

The study examines the role of the largest public works program in the world-the National Rural Employment Guarantee Scheme (NREGS) in buffering the negative effects of early childhood exposure to rainfall shocks on long-term health outcomes. Exploiting the spatial and temporal variation in NREGS coverage, the study estimates the extent to which nutritional insults in early childhood can be off...

Does Money Burn Fat? Evidence from a Randomized Experiment We test whether financial incentives have an effect on weight reduction in a randomized controlled trial involving 700 obese persons assigned to three experimental groups. While two treatment groups obtain €150 and €300, respectively, for achieving an individually assigned target weight within four months, a control group receives no su...

The reliability of general self-rated health status is examined using the reform of the public health insurance system of Germany in 2004 as a source of exogenous variation. Among others, the reform introduced a co-payment for ambulatory doctor visits and increased the co-payments for prescription drugs. This natural experiment allows identifi cation of the causal impact of the program on self-...

Losing Heart? The Effect of Job Displacement on Health Job reallocation is considered to be a key characteristic of well-functioning labor markets, as more productive firms grow and less productive ones contract or close. However, despite its potential benefits for the economy, there are significant costs that are borne by displaced workers. We study how job displacement in Norway affects cardi...

This paper studies externalities of nationally determined cost-sharing systems, in particular coinsurance rates (patients pay a percentage of the price), under pharmaceutical parallel trade, i.e. trade outside the manufacturer’s authorized distribution channel, in a two-country model with a vertical distributor relationship. Parallel trade generates a price-decreasing competition e¤ect in the d...

Flexible Spending Accounts (FSAs) subsidize out-of-pocket health expenses not covered by employerprovided health insurance, making health care cheaper ex post, but also reducing the incentive to insure. We use a cross section of firm-level data to show that FSAs are indeed associated with reduced insurance coverage, and to evaluate the welfare consequences of this shift. Correcting for selectio...

We evaluate how the productive structure and level of specialization of a hospital affect technical efficiency by analyzing a six-year panel database (2000/2005) drawn from hospital discharge records and Ministry of Health data. We adopt a distance function approach, while measuring the technical efficiency level with stochastic frontier techniques. After controlling for environmental variables...