Healthcare

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Topic of This Issue:
Healthcare
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T A B L E O F C O N T E N T S

"The Macroeconomic Consequences of Financing Health Insurance"
STEPHEN B. DELOACH
Elon University - Martha and Spencer Love School of
Business
JENNIFER M. PLATANIA
Elon University

"Health Status, Health Care and Inequality: Canada vs. the U.S."
JUNE O'NEILL
City University of New York - Department of Economics
and Finance, National Bureau of Economic Research (NBER)
DAVE M. O'NEILL
City University of New York - Department of Economics
and Finance

"2007 Health Confidence Survey: Rising Health Care Costs are
Changing the Ways Americans Use the Health Care System"
RUTH HELMAN
Mathew Greenwald & Associates
PAUL FRONSTIN
Employee Benefit Research Institute (EBRI)

"The Macroeconomics of Health Savings Accounts"
JUERGEN JUNG
Indiana University
CHUNG TRAN
Indiana University Bloomington - Department of Economics

"Legal Implications of Proposed GM/UAW VEBA"
STEPHEN F. DIAMOND
Santa Clara University - School of Law

"Employer-Sponsored Health Insurance for Early Retirees: Impacts
on Retirement, Health, and Health Care"
ERIN STRUMPF
McGill University - Department of Economics, McGill
University - Department of Epidemiology, Biostatistics,
and Occupational Health
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"The Macroeconomic Consequences of Financing Health Insurance"

Contact: STEPHEN B. DELOACH
Elon University - Martha and Spencer Love School of
Business
Email: deloach@elon.edu
Auth-Page: http://ssrn.com/author=338595

Co-Author: JENNIFER M. PLATANIA
Elon University
Email: jplatania@elon.edu
Auth-Page: http://ssrn.com/author=452113

Full Text: http://ssrn.com/abstract=1013451

ABSTRACT: Employer-financed health insurance systems, like that
used in the United States, distort firms labor demand and
adversely affect the economy. Since such costs vary with
employment rather than hours worked, firms have an incentive to
increase output by increasing worker hours rather than
employment. Given that the returns to employment exceed the
returns to hours worked, this results in lower levels of
employment and output. In this paper we construct a heterogeneous
agent general equilibrium model where individuals differ with
respect to their productivity and employment opportunities.
Calibrating the model to the U.S. economy, we generate steady
state results for several alternative models for financing health
insurance: one in which health insurance is financed primarily
through employer contributions that vary with employment; a
second where insurance is funded through a non-distortionary,
lump-sum tax; and a third where insurance is funded by a payroll
tax. We measure the effects of each of the alternatives on
output, employment, hours worked and inequality.
______________________________

"Health Status, Health Care and Inequality: Canada vs. the U.S."
NBER Working Paper No. W13429

Contact: JUNE O'NEILL
City University of New York - Department of
Economics and Finance, National Bureau of Economic
Research (NBER)
Email: june_oneill@baruch.cuny.edu
Auth-Page: http://ssrn.com/author=328282

Co-Author: DAVE M. O'NEILL
City University of New York - Department of
Economics and Finance
Email: oneillrsd@aol.com
Auth-Page: http://ssrn.com/author=477480

Full Text: http://ssrn.com/abstract=1016341

ABSTRACT: Does Canada's publicly funded, single payer health care
system deliver better health outcomes and distribute health
resources more equitably than the multi-payer heavily private
U.S. system? We show that the efficacy of health care systems
cannot be usefully evaluated by comparisons of infant mortality
and life expectancy. We analyze several alternative measures of
health status using JCUSH (The Joint Canada/U.S. Survey of
Health) and other surveys. We find a somewhat higher incidence of
chronic health conditions in the U.S. than in Canada but somewhat
greater U.S. access to treatment for these conditions. Moreover,
a significantly higher percentage of U.S. women and men are
screened for major forms of cancer. Although health status,
measured in various ways is similar in both countries,
mortality/incidence ratios for various cancers tend to be higher
in Canada. The need to ration resources in Canada, where care is
delivered free, ultimately leads to long waits. In the U.S.,
costs are more often a source of unmet needs. We also find that
Canada has no more abolished the tendency for health status to
improve with income than have other countries. Indeed, the health
- income gradient is slightly steeper in Canada than it is in the
U.S.
______________________________

"2007 Health Confidence Survey: Rising Health Care Costs are
Changing the Ways Americans Use the Health Care System"
EBRI Notes, Vol. 28, No. 11, November 2007

Contact: RUTH HELMAN
Mathew Greenwald & Associates
Email: RUTHHELMAN@GREENWALDRESEARCH.COM
Auth-Page: http://ssrn.com/author=263460

Co-Author: PAUL FRONSTIN
Employee Benefit Research Institute (EBRI)
Email: FRONSTIN@EBRI.ORG
Auth-Page: http://ssrn.com/author=255140

Full Text: http://ssrn.com/abstract=1030108

ABSTRACT: This paper presents findings from the 2007 Health
Confidence Survey (HCS), the 10th wave of an annual survey to
assess the attitudes of the American public regarding the health
care system in the United States. Findings from the 2007 HCS
demonstrate that rising health care costs increasingly are
changing the way Americans use the health care system. Many of
these changes are positive. Others, such as delaying going to the
doctor and not filling or skipping doses of prescribed
medications, could hurt their health status. Perhaps because of
rising costs, Americans with employment-based health benefits
value it above the actual dollar amount that employers pay toward
the coverage, and many favor an employer mandate (meaning a law
requiring employers to offer or contribute to health insurance
coverage for their workers) that includes all employers,
regardless of size.

The survey was conducted within the United States between May 17
and June 10, 2007, through 20-minute telephone interviews with
1,000 individuals ages 21 and older. Random digit dialing was
used to obtain a representative cross section of the U.S.
population. Interview quotas were established by sex of
respondent and employment status, and the data were weighted by
gender, age, education, and employment status to reflect the
actual proportions in the population. The HCS is co-sponsored by
the Employee Benefit Research Institute (EBRI), a private,
nonprofit, nonpartisan public policy research organization, and
Mathew Greenwald & Associates, Inc., a Washington, D.C.-based
market research firm.
______________________________

"The Macroeconomics of Health Savings Accounts"
CAEPR Working Paper No. 2007-023

Author: JUERGEN JUNG
Indiana University
Email: juejung@indiana.edu
Auth-Page: http://ssrn.com/author=523107

Co-Author: CHUNG TRAN
Indiana University Bloomington - Department of
Economics
Email: chtran@indiana.edu
Auth-Page: http://ssrn.com/author=535250

Full Text: http://ssrn.com/abstract=1024556

ABSTRACT: We analyze whether a consumer driven health care plan
like the newly established Health Savings Accounts (HSAs) can
reduce health care expenditures in the United States and increase
the fraction of the population with health insurance. We use an
overlapping generations model with health uncertainty and
endogenous health care spending. Agents can choose between a low
deductible- and a high deductible health insurance. If agents
choose to purchase the high deductible health insurance, they are
allowed to contribute tax free to an HSA. We examine the steady
state effects of introducing HSAs into a system with private
health insurance for young agents and Medicare for old agents.
Since the model is a general equilibrium model, we fully account
for feedback effects from both, factor markets and insurance
markets. Our results from numerical simulations indicate that
HSAs can decrease total health expenditures by up to 3% of GDP
but increase the number of uninsured individuals by almost 5%.
Furthermore, HSAs decrease the aggregate level of health capital
and therefore decrease output. We also address possible
extensions of the HSA reform that include the eligibility to pay
health insurance premiums with HSA funds, the full privatization
of Medicaid via HSAs, and Medicare for workers.
______________________________

"Legal Implications of Proposed GM/UAW VEBA"

Contact: STEPHEN F. DIAMOND
Santa Clara University - School of Law
Email: sdiamond@scu.edu
Auth-Page: http://ssrn.com/author=333619

Full Text: http://ssrn.com/abstract=1025001

ABSTRACT: This research note provides an initial exploration of
the potential securities law implications of the proposed
Voluntary Employees Beneficiary Association (VEBA) of General
Motors and the UAW.
______________________________

"Employer-Sponsored Health Insurance for Early Retirees: Impacts
on Retirement, Health, and Health Care"

Contact: ERIN STRUMPF
McGill University - Department of Economics, McGill
University - Department of Epidemiology,
Biostatistics, and Occupational Health
Email: erinstrumpf@gmail.com
Auth-Page: http://ssrn.com/author=384055

Full Text: http://ssrn.com/abstract=1032963

ABSTRACT: The proportion of large employers offering retiree
health insurance in the U.S. has declined by half in the past 20
years. This paper examines the potential implications of this
change by estimating the effects of a retiree health insurance
(RHI) offer on a comprehensive set of labor, health and health
care use outcomes in the near-elderly population.

The analysis is based on ten years of longitudinal data from the
Health and Retirement Survey (1992-2002). After restricting to
respondents who have employer-sponsored health insurance at
baseline, I find that an RHI offer increases the probability of
early retirement by 35 percent for both men and women. An RHI
offer decreases the probability of being uninsured by 55 percent,
while increasing the probability of employer-sponsored coverage
and decreasing the probability of public coverage. There is
suggestive evidence that individuals with an RHI offer are more
likely to visit the doctor, use prescription drugs on a regular
basis and have outpatient surgery. While we see no significant
effect on health, RHI provides significant protection from high
out-of-pocket medical costs. In the top 40 percent of the
out-of-pocket spending distribution, those with an offer of
retiree coverage spend 21 percent less on average.

Estimates of the value of RHI of over $3,000 per year suggest
that increasing opportunities for the near-elderly to purchase
coverage at actuarially-fair prices through the individual market
or public programs could significantly increase insurance
coverage and reduce financial risk for this age group.