Now showing 1 - 10 of 19
  • Publication
    Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California
    (University College Dublin. School of Economics, 2009-01) ;
    Rural hospitals play a crucial role in providing healthcare to rural Americans, a vulnerable and underserved population; however, rural hospitals have faced threats to their financial viability and many have closed as a result. This paper examines the hospital characteristics that are associated with patients choosing rural hospitals, and sheds light on the types of patients who depend on rural hospitals for care and, hence, may be the most impaired by the closure of rural hospitals. Using data from California hospitals, the paper shows that patients were more likely to choose nearby hospitals, larger hospitals, and hospitals that offered more services and technologies. However, even after adjusting for these factors, patients had a propensity to bypass rural hospitals in favor of large urban hospitals. Offering additional services and technologies would increase the share of rural residents choosing rural hospitals only slightly.
  • Publication
    Health insurance transitions after retirement : did HIPAA expand coverage for retirees?
    (University College Dublin; School of Economics, 2006-11) ;
    The near elderly are a vulnerable segment of the population with high-expected medical expenses. Individuals who retire before Medicare eligibility may lose employer provided health insurance, and may face a potentially costly uninsured period. We use data from the Health and Retirement Study from 1992 to 2002 to profile the insurance status of workers who retire. We also evaluate the role of the Health Insurance Portability and Accountability Act (HIPAA) in reducing the number of uninsured among the near elderly. We find that a relatively small proportion of workers lose health insurance on retirement; however, we find no evidence that HIPAA has helped these workers to remain insured.
  • Publication
    Private Health Insurance in Ireland: Trends and Determinants
    (University College Dublin. School of Economics, 2019-02)
    This study examines the determinants of demand for private health insurance in Ireland. Survey data commissioned by the Health Insurance Authority from 2009 to 2017 are used to estimate multivariate models of health insurance demand. The results show that older and sicker individuals are more likely to have private health insurance. Irish-born are found to be more likely to have private health insurance. Preferences for health insurance also play an important role in predicting the purchase of health insurance. After controlling for the role of socio-economic factors and individual preferences, annual variations in the economy are not found to affect private health insurance coverage.
  • Publication
    The impact of health on job mobility : a measure of job lock
    (Cornell University; School of Industrial & Labor Relations, 1998-01)
    The author analyzes data from the National Medical Expenditure Survey of 1987 to measure the importance of "job lock"-the reduction in job mobility due to the non-portability of employer-provided health insurance. Refining the approach commonly used by other researchers investigating the same question, the author finds insignificant estimates of job lock; moreover, the confidence intervals of these estimates exclude large levels of job lock. A replication of an influential previous study that used the same data source shows large and significant job lock, as did that study, but when methodological problems are corrected and improved data are used to construct the job lock variables, job lock is found to be small and statistically insignificant.
  • Publication
    Is the individual market more than a bridge market? An analysis of disenrollment decisions
    The individual insurance market is perceived by many to provide primarily transition coverage, but there is limited research about how long people stay in this market and what affects their disenrollment decisions. We examine these issues using administrative records and survey data for those enrolled in the individual market in California. We conclude that there is less turnover in this market than is commonly believed. We find that economic factors and coverage characteristics are important in the decision to disenroll, but that perceptions about insurance and the health care system also affect this decision.
  • Publication
    The role of health insurance in joint retirement among married couples
    (University College Dublin. School of Economics, 2006-11) ;
    This paper examines the role of employer provided health insurance in the retirement decisions of dual working couples. The near elderly have high-expected medical expenditures; therefore, availability of health insurance is an important factor in their retirement decisions. We determine if access to retiree health insurance for early retirement enables couples to time their retirement together – a behavior called “joint retirement.” We find that wives’ retiree health insurance more than doubles the propensity to retire jointly, suggesting that health insurance is an important consideration in coordinating retirement decisions among couples. Even though retiree health insurance has a substantial effect on joint retirement, its effect on overall employment patterns is modest, accounting for a 2 percentage point fall in employment.
  • Publication
    Family decision making when two workers are offered group coverage
    (Employee Benefits Security Administration, U.S. Department of Labor, 2004) ;
  • Publication
    The role of health insurance in joint retirement among married couples
    (School of Industrial and Labor Relations Cornell University, 2007-04) ;
    Because the near-elderly have high expected medical expenditures, availability of health insurance is an important factor in their retirement decisions. Using Health and Retirement Study data collected in 1992-2002, the authors of this study investigate whether access to employer-provided retiree health insurance enabled dual working couples to time their retirement together--a behavior called "joint retirement." They find that when wives had employer-provided retiree health insurance, the likelihood of joint retirement more than doubled. The effect of retiree health insurance on overall employment patterns, in contrast, was modest: estimates indicate that a hypothetical change from universal availability of such insurance to its universal unavailability would have increased employment levels by only two percentage points.
  • Publication
    Individual health insurance within the family : can subsidies promote family coverage?
    This paper examines the role of price in health insurance coverage decisions within the family to guide policy in promoting whole family coverage. We analyze the factors that affect individual health insurance coverage among families, and explore family decisions about whom to cover and whom to leave uninsured. The analysis uses household data from California combined with abstracted individual health plan benefit and premium data. We find that premium subsidies for individual insurance would increase family coverage; however, their effect likely would be small relative to their implementation cost.
  • Publication
    Is employer-based health insurance a barrier to entrepreneurship?
    (University College Dublin. School of Economics, 2009-01) ; ;
    The focus on employer-provided health insurance in the United States may restrict business creation. We address the limited research on the topic of “entrepreneurship lock” by using recent panel data from matched Current Population Surveys. We use difference-indifference models to estimate the interaction between having a spouse with employer-based health insurance and potential demand for health care. We find evidence of a larger negative effect of health insurance demand on the entrepreneurship probability for those without spousal coverage than for those with spousal coverage. We also take a new approach in the literature to examine the question of whether employer-based health insurance discourages entrepreneurship by exploiting the discontinuity created at age 65 through the qualification for Medicare. Using a novel procedure of identifying age in months from matched monthly CPS data, we compare the probability of business ownership among male workers in the months just before turning age 65 and in the months just after turning age 65. We find that business ownership rates increase from just under age 65 to just over age 65, whereas we find no change in business ownership rates from just before to just after for other ages 55-75. Our estimates provide some evidence that "entrepreneurship lock" exists, which raises concerns that the bundling of health insurance and employment may create an inefficient allocation of which or when workers start businesses.