Journal of health economics
-
We examine the marginal effects of decentralized public health spending by incorporating estimates of behavioural responses to changes in health spending in benefit incidence analysis. The analysis is based on a panel dataset of 207 Indonesian districts over the period from 2001 to 2004. We show that district public health spending is largely driven by central government transfers, with an elasticity of around 0.9. ⋯ We find no evidence that public expenditures crowd out utilization of private services or household health spending. Our analysis suggests that increased public health spending improves targeting to the poor, as behavioural changes in public health care utilization are pro-poor. Nonetheless, most of the benefits of the additional spending accrued to existing users of services, as initial utilization shares outweigh the behavioural responses.
-
This paper exploits the discontinuity created by the minimum legal drinking age of 21 years to estimate the causal effect of increased alcohol availability on marijuana use. We find that consumption of marijuana decreases sharply at age 21, while consumption of alcohol increases, suggesting that marijuana and alcohol are substitutes. We further find that the substitution effect between alcohol and marijuana is stronger for women than for men. Our results suggest that policies designed to limit alcohol use have the unintended consequence of increasing marijuana use.
-
Growth in the number of days between an appointment request and the actual appointment reduces demand. Although such waiting times are relatively low in the US, current policy initiatives could cause them to increase. We estimate multiple-equation models of physician utilization and insurance plan choice for Medicare-eligible veterans. We find that a 10% increase in VA waiting times increases demand for Medigap insurance by 5%, implying that a representative patient would be indifferent between waiting an average of 5 more days for VA appointments and paying $300 more in annual premium.
-
This paper contributes to the growing literature on the relationship between business cycles and mental health. It is one of the first applications in the economics literature to incorporate data on web searches from Google Insights for Search, and these unique data allow the opportunity to estimate the association between weekly unemployment insurance (UI) claims, in addition to monthly unemployment rates, and search indexes for "depression" and "anxiety". Results from state fixed effects models yield (1) a positive relationship between the unemployment rate and the depression search index and (2) a negative relationship between initial UI claims on the one hand and the depression and anxiety search indexes on the other. A lag analysis also shows that an extended period of higher levels of continued UI claims is associated with a higher depression search index.
-
The recent growth of the home care sector combined with societal and demographic changes have given rise to concerns about the adequacy of the supply of family and friend caregivers. Potential caregivers face competing time pressures that pull them in the direction of the labour market on one hand, and towards unpaid caregiving duties on the other. ⋯ Results suggest that caregivers are heterogeneous in both their caregiving inputs and associated labour market responses, thereby underscoring the importance of controlling for caregiving intensity when measuring labour supply. The negative influence of primary caregiving on labour supply appears to be at the level of labour force participation, rather than on hours of work or wages.