ec2465 syllabus spring 2011 Jan 21.docx - iSites

guiltlesscyanΒιοτεχνολογία

3 Δεκ 2012 (πριν από 4 χρόνια και 10 μήνες)

268 εμφανίσεις

Spring 2011

Economics 24
65
:
Health Economics




David Cutler

Littauer 230

Telephone:
6
-
5216

e
-
mail:
dcutler@harvard.edu


Office Hours: By
Appointment
,
dingwell@fas.harvard.edu




______________________________________________________________________
_______


This is
a course in the economics of health care.
Topics will include
health capital, global health,
health insurance, productivity of medical spending, and medical care markets.


Meeting
:

Class is scheduled
for
Tuesday
,
Thursday,
and Friday, from
2
:30
-

4
:00 pm. Class
will generally meet twice per week, with a few
exceptions. Check the meeting
schedule carefully.


Seminar
:

Students are strongly encouraged to attend the weekly
Health Economics
seminar.
The seminar meets
Wednesdays
from 4:
3
0
-
6:0
0.
See
http://www.bu.edu/econ/seminars
-
workshops/seminars/health/

for schedule.


Grading
:

There will be a

4

problem sets and
6 article critiques during the semester
(30%)
.
In addition, s
t
udents must write a term paper
on a topic of their choosing, due the
last day of reading period
, May 5, 2011

(70%).








ECON 2465 Spring 2011

Page
2


Economics 2465 Lecture Schedule


Health Capital

Tue

January 2
5


1. Health Capital

Thu

January 2
7


No Class

Fri

J
anuary 2
8


2.
Education and Health


Global Health

Tue

February
1


3. Health Behaviors







Thu

February
3


4. Health
o
ver Time, and Around the World


Problem s
et 1

Fri

February
4


No Class


Tue

February
8


5. Disease and Development: Macro Studies



Thu

February
10


6. HIV/AIDS






Article
c
ritique 1

Fri

February 1
1


No Class


Tue

February 1
5


7. Disease and Development: Micro Studies


Thu

February 1
7

8. Early Life Health and Productivity


Article critique 2

Fri

February 1
8


No Class


Tue

February

2
2


No Class

Thu

February 2
4


9. Family Planning and Family Resources

Fri

February 2
5


10. Health Systems





Problem set 2



Health Insurance

Tue

March
1



11. Optimal insurance I

Thu

March
3



12. Optimal insurance II




Article critique 3

Fri

March
4



No Class


Tue

March
8



13. Selection

Thu

March 10


14. Health insurance and labor markets


Article critique 4

Fri

March 1
1


No Class


March 1
5

SPRING BREAK

March 1
7

SPRING BREAK

March 1
8

SPRING BREAK


Tue

March 2
2


15. Public insurance:
Disability Insurance

Thu

March 2
4


No Class

Fri

March 2
5


16. Public insurance: Medicare Part D


Problem set 3



Productivity Analysis

Tue

March
29


17. Productivity I

Thu

March 31


No Class

Fri

April 1




18. Productivity II
[meet at 3:30]



Article

critique

5


ECON 2465 Spring 2011

Page
3


Medical Care Markets

Tue

April
5



19. Physician behavior

Thu

April
7



No Class


Fri

April
8


No Class



Tue

April 1
2



20. The health care workforce



Article critique 6

Thu

April 1
4



21. Hospital Behavior

Fri

April 15


22. Competition in Health Care


Tue

April
19



23. Medical Malpractice




Problem set 4

Thu

April 2
1



No Class


Fri

April 2
2



No Class



Tue

April 26


24.
The Life Cycle of Technology








ECON 2465 Spring 2011

Page
4


A Note on Readings


Readings in health economics are
in several journals:


General interest journals
:
American Economic Review, Journal of Political Economy,
Quarterly Journal of Economics, Econometrica


Field journal
s
:
The major journal in the field is the
Journal of Health Economics


Medical journals
:
Almost all medical journals publish health economics articles. The best are
the
New England Journal of Medicine

and

JAMA
.
Each will send you weekly summaries of
what is in the journal if you wish.


Policy journals
:
Health Affairs

has a number of good
ar
ticles on health care policy topics.


Reference books
:
T
here is no textbook in the field. The best collection is the
Handbook of
Health Economics
, edited by Tony Culyer

and Joe Newhouse. It is now a bit dated (2000). For
an undergraduate introduction, try
Sherman
Folland
, Allen Goodman, and Miron Stano,
The
Economics of Health and Health Care
.
Any edition
is
fine.





1


I. Health Capital


Lecture 1
:
Health Capital


Key points:



Health as a consumption and investment good



Value of survival is linear in flow utility
(not marginal utility)



H
ealth improvements are worth a lot




Classic
paper

Grossman, Michael,

“On the Concept of Health Capital and the Demand for Health
,

Journal of
Political Economy
, 1972, 80(2)
,
223
-
255.


Theory

Case, Ann
e

and Angus Deaton, “Broken Down by Work and Sex: How Our Health Declines,” in
D
avid

Wise
, ed
.
,

Advances in the Economics of Aging
,

Chicago:
University of Chicago Press,
2005.


Grossman, Michael,

The Human Capital Model,


in
Anthony J. Culyer and Joseph P.
Newhouse,
eds.,
Handbook of Health Economics
, Amsterdam: North
-
Holland, 2000.


Hall, Robert E. and
Charles I.
Jones
,


The Value of Life and the Rise in Health Spending,


Quarterly Journal of Economics
,

2007,
122 (1)
,
39
-
72.


Murphy, Kevin M. and Robert H.

Topel
,

The Value of Health and Longevity,


Journal of
Political Economy
,
2006,

114 (5)
,
871
-
904.


Empirical analysis

Becker, Gary S.,
Tomas J. Philipson
, and
Rodrigo R. Soares
,

The Quantity and Quality of Life
and the Evolution of World Inequality
,”
American Economic Review
,
2005
, 95(1)
,
277
-
291
.


Nordhaus
, William
,

The Health of
Nations: The Contribution of Improved Health to Living
Standards
,


in K
evin

Murphy and R
obert

Topel, eds.,
Measuring the Gains from Medical
Research
:
An Economic Approach
. Chicago: University of Chicago Press, Spring 2003.



L
ecture 2:
Education and
Health


Key points:



The ‘gradient’ in health



Education is causally related to health



The reason why is unclear, though may have to do with cognitive processing


Case, Anne, Darren Lubotsky, and Christina Paxson, “
Economic Status and Health in Childhood:
The Origins of the Gradient,”
American Economic Review
, 2002, 92(5)
,
1308
-
1334.


2


Currie, Janet, and Enrico Moretti
, “Mother's Education and the Intergenerational Transmission of
Human Capital: Evidence from College Openings,”
Quarterly Journal of Economics
, 2003,
118(4)
,
1495
-
1532.


Cutler, David and Adriana Lleras
-
Muney, “Understanding Differences in Health Behavior
by
Education
,

Journal of Health Economics
, 2010, 29(1), 1
-
28
.


Goldman, Dana
,

and
James
Smith
,


Can patient self
-
management help explain the SES health
gradient?”
Proceedings of the National Academy of Science
,
2002,
99
(16), 10929
-
34
.


Lleras
-
Muney, Adriana, “The Relationship Between Education and Adult Mortality in the U.S.,”
Review of Economic Studies
, 2005, 72(1)
, 189
-
221
.



Lecture 3
:
Health
Behaviors


Key points:



Behaviors are a key ‘actual cause’ of death




I
nternal
ities


are more important than externalities



Models of behavior


Actual Causes of Death

Mokdad, Ali H.,
James S. Marks, Donna F. Stroup, and Julie L. Gerberding, “Actual Causes of
Death in the United States, 2000,”
JAMA
, 2004, 291(1), 1238
-
1245.



Smoking

Chaloupka, Frank

and Kenneth E. Warner, “The Economics of Smoking”,
in
Anthony J. Culyer
and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
, Amsterdam: North
-
Holland,
2000.


De Walque, Damien
, “Education, inf
ormation, and smoking decisions
: evidence from smoking
histories, 1940
-
2000,”
Journal of Human Resources
, 2010,
45(3), 682
-
717.


Gruber, Jonathan,

Tobacco at the Crossroads: The Past and Future of Smoking Regulation in
the United States.


Journal of Economic Perspectives
,

2001,
15 (2)
,
193
-
212.



Manning, Willard
,

Emmett Keeler, Joseph Newhouse, Elizabeth Sloss, and Jeffrey Wasserman
,


The Taxes of Sin: Do Smokers and Drinkers Pay Their Way?


JAMA
, 1989,

261(11)
,
1604
-
9.


Models of Health Behaviors

Becker, Gary, and Kevin Murphy, “A Theory of Rational Addiction,”
Journal of Political
Economy
, 1988, 96(4), 675
-
700.


Bernheim, B. Douglas, and Antonio Rangel, “Addiction and Cue
-
Triggered Decision Processes,”
American Economic Review
, 2004, 94(5)
,
1558
-
9
0.


3


Gruber, Jonathan and Botond Koszegi,

Is Addiction '
Rational'? Theory and Evidence,”

Quarterly Journal of Economics
, 2001, 116(4), 1261
-
1303
.


Laibson
, David,
“Golden Eggs and Hyperbolic Discounting
,

Quarterly Journal of Economics
,
1997,
112(2),
443
-
477.


II.

Global Health


Lecture
4
: Health
o
ver Time and Around the World


Key points:



Health has improved enormously in recent centuries



Health
co
varies
positively
with income, with
interesting
exceptions



The debate about causality between health
and development



Classic paper

Fogel, Robert W., “Economic Growth, Population Theory, and Physiology: The Bearing of
Long
-
Term Processes on the Making of Economic Policy
,

American Economic
R
eview
,

1994
,
84(3
), 369
-
395.


Other readings

Bloom, David E. and

David Canning
,

“The Health and Wealth of Nations,”
Science
, 2000,

287
(5456)
, 1207
-
1208.


Brainerd, Elizabeth, and David Cutler, “Autopsy on an Empire: Understanding Mortality in
Russia and the Former Soviet Union,”
Journal of Economic Perspectives
, 2005,
19(1), 107
-
130.


Case
, Anne

and Angus Deaton. 2009. “Health and Well Being in Udaipur and South Africa,” in
David Wise, ed.,
Developments in t
he Economics of Aging
, Chicago:
University of Chicago
Press.


Cutler, David, Angus Deaton, and Adriana Lleras
-
Muney,

The Determinants of Mortality,


Journal of Economic Perspectives
,
2006,
20(3), 97
-
120.


Deaton, Angus, “The Great Escape: A Review of Robert Fogel’s The Escape from Hunger and
Premature Death 1700
-
21
00”
Journal of Economic Literature
, 2006, 44(1),
106
-
114.


Strauss, John, and Duncan Thomas, “Health, Nutrition, and Economic Development,”
Journal of
Economic Literature

1998,
36(2), 766
-
817.






4


Lecture 5
:
Disease and Development
: Macro Studies


Key
points:



The channels by which disease and development might be linked



The empirical impact
of disease on development
is difficult to
determine


Acemoglu, Daron, and Simon Johnson,

Disease and Development: The Effect of Life

Expec
-
tancy on Economic Growth
,


Journal of Political Economy
,

115 (6), December 2007, 925
-
985.


Ashraf,
Quamrul H., Ashley
Lester, and
David N.
Weil
, “When Does Improving Health Raise
GDP?”
NBER Macroeconomics Annual
, 2009.


Gallup, John Luke and Jeffrey D. Sachs, “The Economic Burden of Malaria,” Supplement to
The
American Journal of Tropical Medicine & Hygiene
,
2001, 64(
1
-
2 Supplement)
, 85
-
96
.


Jack, William, and Maureen Lewis, “Health
Investments and Economic Growth:
Macroeconomic Evidence with Microeconomic Foundations,” chapter 1 in Michael Spence and
Maureen Lewis,
Health and Growth
, World Bank, Commission on
Growth and Development,
available online.


Pritchett, L
ant

and L
awrence

Summers, “Wealthier is Healthier,”
Journal of Human Resources,

1996, 31, 841
-
868.


Sachs, Jeffrey, and Pia Malaney, “The Economic and Social Burden of Malaria,”
Nature
, 2002,
415(6872), 680
-
685.



Lecture
6
:


HIV/AIDS


Key points:



The enormous impact of HIV/AIDS on world health



The impact
of HIV on the economy



Why have behavioral changes not been larger?


Alsan, Marcella and

David Cutler, “The ABCDs of Health: Explaining the Reduction in AIDS
Mortality in Uganda,


mimeo, 2010.


Canning, David,
“The Economics of HIV/AIDS in Low Income Cou
ntr
ies: The Case for
Prevention,

The Journal of Economic Perspectives
, 2006, 20
(3)
,

121
-
142.


Dupas, Pascaline,
“Relative Risks and the Market for Sex: Teenage Pregnancy, HIV, and

Partner Selection in Kenya
,” mimeo, 2007.


Gertler, Paul, Manis
ha

Shah and Stefano M Bertozzi,

“Risky Business: The Market for
Unprotected Commercial Sex
,

Journal of Political Economy
, 2005,
113 (3), 518
-
550.


5


Oster
, Emily
,

“Sexually Transmitted Infections, Sexual
Behavior, and HIV/AIDS Epidemic,


Quarterly Journal of
Economics
,
2005,
120(2),

467
-
515.


Philipson, Thomas,
“Economic Epidemiology and Infectious Diseases,”
in
Anthony J. Culyer
and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
, North
-
Holland, 2000.


Thornton, Rebecca,

“The Demand for and Impact of Learning HIV Status: Evidence from a Field
Experiment
,”
American Economic Review
, 2008, 98(5), 1829
-
1863.


Young, Alwyn,
“The Gift of Dying: The Tragedy of AIDS and the Welfare of Future African
Generations.”
Quarterly Journa
l of Economics
,
2005,
120
(2)
,

423
-
466.



Lecture
s

7

and 8
:
Disease and Development: Micro Studies


Key points:



There is a clear relation between disease and development in micro studies



The impact if often smaller than macro studies suggest


David N. Weil,

Accounting for The Effect of Health on Economic Growth,


Quarterly Journal
of Economics
, 2007, 122(3), 1265
-
1306.


Hookworm

Bleakley, Hoyt, “Disease and Development: Evidence from Hookworm Eradication in the
American South,”
Quarterly
Journal of Economics
, 2007
, 122
(1), 73
-
117.


Miguel, Edward and Michael Kremer,

Worms: Identifying Impacts on Education and Health in
the Presence of Treatment Externalities,


Econometrica
,

2004, 72(1),

159
-
217.


Malaria

Bleakley
, Hoyt,

Malaria
Eradication in the Americas: A Retrospective Analysis of Childhood
Exposure
,”
American Economic Journal: Applied Economics
,
2010
, 2(2),

1
-
45.


Cutler, David M., Winnie

Fung,

Michael

Kremer,

Monica

Singhal,
and Tom
Vogl,


Early
-
life
Malaria Exposure and
Adult Outcomes: Evidence from Malaria Eradication in India
,”
American
Economic Journal: Applied Economics
,
2010
, 2(2),
72
-
94,


Lucas
, Adrienne,
“Malaria Eradication and Educational Attainment: Evidence from Paraguay and
Sri Lanka,”
American Economic
Journal: Applied Economics
,

2010
, 2(2),

46
-
71.


Malnutrition

Field, Eric
a, Omar Robles and Maximo Torero, “
Iodine deficiency and schooling attainment

in
Tanzania
,”

American Economic Journal: Applied Economics
, 2009, 1(4), 140

69.


Thomas, Duncan, et al.
,

“Iron Deficiency and the Well
-
Being of Older Adults: Early Results
from a Randomized Nutrition Intervention,”
mimeo, 2003.

6



Clean Water

Kremer, Michael
, Jessica

Leino,

Edward

Miguel,
and Alix Peterson Zwane, “
Spring Cleaning: A
Randomized Evaluation of
Source Water Improvement
,”
Quarterly Journal of Econo
mi
cs
,
forthcoming
.


Early Life Health, Schooling, and Productivity

Almond, Doug
,
“Is the

1918 Influenza Pandemic Over?
Long
-
Term Effects of In Utero Exposure
in
the Post
-
1940 US Population,”
Journal of
Political Economy
, 2006, 114(4), 672
-
712.


Almond, Doug, Lena Edlund, and M
å
rten Palme, “
Chernobyl’
s Subclinical Legacy: Prenatal
Exposure to Radioactive Fallout and School Outcomes in Sweden,”
Quarterly Journal of
Economics,
2009,
124(
4
), 1729
-
1772.

Almon
d, Doug and Kenneth Chay
,
“The Long Run and Intergenerational of Poor Infant Health:
Evidence from Cohorts B
orn during the Civil Rights Era,” mimeo, 2006.


Maccini, Sharon and Dean Yang
,

“Under the Weather: Health, Schooling and Socioeconomic
Cons
equences
of Early Life Rainfall,
American Economic Review
, 2009, 99(3), 1006
-
1026.


Steckel, Richard, “
Stature
a
nd the Standard of Living
,

Journal of Economic Literature
,

1995,
33(4), 1903

-
19
40.



Lecture 9:
Family Planning and Resources


Key points:



Family
planning is associated with improved outcomes



The allocation of resources within the family matters along with overall family resources


Family Planning

Miller, Grant,

Contraception as Development?

New Evidence F
rom Family Planning in
Columbia,

The
Economic Journal
,
2010,
120(545), 709
-
736.


Pop
-
Eleches, C
hristian,

“The Impact of an Abortion Ban on Socio
-
Economic Outcomes of
Children: Evidence from Romania,”
Journal of Political Economy
, 2006, 114(4), 744
-
773.


The Impact of Intra
-
Household
Resource
Distribution

Ashraf, Nava
,

“Spousal Control and Intra
-
household Decision Making: An Experimental Study
in the Philippines
,

American Economic Review
, 2009, 99(4), 1245
-
1277.


Glewwe, P
aul
,

Why Does Mother’s Schooling Raise Child Health in Developing
Countries?
Evidence from Morocco,


Journal of Human Resources
,

1999,
34(1): 124
-
159.


Qian, N
ancy
,


Missing Women and the Price of Tea in China: The Effect of Sex
-
specific Income
on Sex Ratios,


Quarterly Journal of Economics
,
2008, 123(3), 1251
-
1285
.


7


Udry, Christopher,


Gender, Agricultural Production, and the Theory of the Household
,


Journal
of Political Economy
,

1996,
104
(
5
),

1010
-
1045.


Wolfe B
arbara
L
.

and J
ere R Behrman,

“Women's schooling and children's health: Are the
effects robust with adult sibling control for the women's childhood background?”
Journal of
Health Economics
,

1987,
6(3)
,
239
-
54.



Lecture 10:
Health Systems


Key points:



The basics of a health system



Supply versus demand
-
side restrictions



Problems of supply:
Provider competence and attendance



Evidence on the operation of different systems


Developed Countries

Cutler, David M., “Equality, Efficiency, and Market Fundamentals: The Dynamics of
Internationa
l Medical Care Reform,”
Journal of Economic Literature
, 2002, 40(3), 881
-
906.


Rawlings, Michael D., “
NICE Work


Providing Guidance to the British National Health
Service
”,
New England Journal of Medicine
, 2004, 351(14), 1383
-
5.


Developing Countries
(esp. China and India)

B
lumenthal, David and William Hsiao, “
Privatization and Its Discontents: The Evolving Chinese
Health System
,”
New England Journal of Medicine
, 2005, 353(11), 1165
-
1170.




Chaudhury, Nazmul, et al.
,


Missing in Action: Teacher and Health Worker
Absence in
Developing Countries,”
Journal of Economic Perspectives
,

2006,
20(1)
,

91
-
116.


F
ilmer, Deon and Lant Pritchett,
“The Impact of Public Spending on Health: Does Money
Matter?”
Social Science and
Medicine
, 1999
,

49
(10),

1309
-
1323.


Das
, Jishnu

and Jeffrey Hammer,


Money for nothing: The dire straits of

m
edical practice in
Delhi, India,”

Journal of Development Economics
, 2007,
83
(1),

1
-
36.


Conditional Cash Transfers

Gertler, Paul
,

“Do Conditional Cash Transfers Improve Child Health? Evidence from
PROGRESA’s Control Randomized Experiment,”
American Economic Review
,

2004, 94(1),
336
-
341.





8


III: Health Insurance


Lectures 11&12:
Optimal Health Insurance


Key points:



How people get

insurance coverage

in the United States



The
balance

between risk spreading and
moral
hazard



Empirical evidence on demand elasticity



Is current insurance optimal?



Managed care



Empirical evidence on health insurance and health


Classic paper
s

Arrow, K
enneth
. “Uncertainty and the Welfare Economics of Medical Care,”
American
Economic Review
, 1963,
53(5)
,

941
-
973.


Feldstein,
Martin,
“The Welfare Loss of Excess Health Insurance”,
Journal of Political
Economy
, 81(2), part I, March
-
April 1973, 251
-
280.


T
heory of Optimal Insurance

Cutler, D
avid

and R
ichard
Zeckhauser, “The Anatomy of Health Insurance,” in Anthony J.
Culyer and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
, Amsterdam:
North
-
Holland, 2000, Sections 1
-
5
, 8
.


Pauly, Mark V., and F
red
ric

E. Blavin, “Moral hazard in insurance, value
-
based cost sharing, and
the

benefits of blissful ignorance,”
J
ournal of
Health Econ
omics
, 2008,

27(6)
,
1407
-
14
17.


The Moral Hazard Debate

Manning
, Willard
et al., “Health Insurance and the Demand for
Medical Care: Evidence from a
Randomized Experiment
,

American Economic Review
,
1987,
77(3), 251
-
177.


Chandra,
Amitabh,
Jonathan Gruber, and Robin McKnight,

Patient Cost
-
Sharing and
Hospitalization Offsets in the Elderly,


American Economic Review
,
2010,

100(1), 1
-
24.


Gladwell, Malcolm, “The Moral Hazard Myth,”
The New Yorker
, August 29, 2005.


Huskamp, Haiden, et al.,

The Effect of Incentive
-
Based Formularies on Prescription
-
Drug
Utiliza
tion and Spending
,”
New England Journal of Medicine
,
2003 349
2224
-
2232.


Nyman, J
ohn,

“The Value of Health Insurance: The Access Motive,”
Journal of Health
Economics
,
1999,
18(2)
,

141
-
152.


Managed Care

Cutler, David, Joseph P. Newhouse, and Mark McClellan, “How Does Managed Care Do It?”
Rand Journal of Economics
, 2000,
31(3), 526
-
548.

9


Glied
, Sherry, “Managed Care”,
in
Anthony J. Culyer and Joseph P. Newhouse,
eds.,
Handbook
of Health Economics
,
Amsterdam: North
-
Holland, 2000.


Medicare
, Medicaid,

and
H
ealth

Card, David, Carlos Dobkin, Nicole Maestas, “Does Medicare Save Lives?”
Quarterly Journal
of Economics
,
2009,

124
(2),

597

636.


Chay, Ken, Daeho Kim, an
d

Shailender Swaminthan, “Medicare,
Hospital Utilization and
Mortality: Evidence from the Program's Origins,” mimeo, September 2009.


Currie,
Janet,
and J
onathan

Gruber, “Saving Babies: The Efficacy and Cost of Recent
Expansions of Medicaid Eligibility for Pregnant Women”,
Journal of Politic
al Economy
, 1996,
104(6), 1263
-
1296.


Finkelstein, Amy, 2007, “The Aggregate Effects of Health Insurance: Evidence from the
Introduction of Medicare,”
Quarterly Journal of Economics
, 122(1),
1
-
37.


Levy, Helen and David Meltzer, “The Impact of Health In
surance on Health,”
Annual Review of
Public
Health
, 2008, 29, 399
-
409.


Piper,
Joyce,
et al., “Effects of Medicaid Eligibility Expansion on Prenatal Care and Pregnancy
Outcomes in Tennessee
,

J
AMA
,
1990,
264
(17)
, 2219
-
2223.



Lecture 1
3
:
Selection


Key
points:



Perfect and imperfect information in insurance
are each
problematic



The right model of insurance choice is difficult



Market design is a major issue


Classic paper
s

Akerlof, George A., “
The Market for 'Lemons': Quality Uncertainty and the Market
Mechanism,”
Quarterly Journal of Economics
,
1970
, 84(3), 488
-
500.


Rothschild
, Michael

and J
oseph E.

Stiglitz,

Equilibrium in Competitive Insurance Markets: An
Essay on the Economics of Imperfect

Information

,
Quarterly Journal of Economics
,
1976,
90(4), 629
-
650.


Other Readings

Cutler,
David,
A
my

Finkelstein, and K
athleen

McGarry,

Preference Heterogeneity and
Insurance Markets
,


American Economic Review
,
2008,

98(2),
157
-
62.


Cutler
, David,

and S
arah

Reber,

Paying for Health Insurance: The Tradeoff Between
Competition and Adverse Selection
,


Quarterly Journal of Economics
, 1998,
113(2),
433
-
466.


10


Cutler, D
avid

and R
ichard
Zeckhauser, “The Anatomy of Health Insurance,” in Anthony J.
Culyer

and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
, Amsterdam:
North
-
Holland, 2000, Sections
6
-
7.


Ericson,
Keith,

Sophistication and Insurance
,” mimeo, 2009.


Finkelstein, Amy
and K
athleen

McGarry,

Multiple dimensions of private information: evidence
from the long
-
term care insurance market
,


American Economic Review
2006,
96(4), 938
-
958
.


Mar
ket Design

Chernew, Michael, Gautam Gowrisankaran, and Dennis P. Scanlon.

Learning and the Value of
Information: Evidence from Health Plan Report Cards
,”

Journal of Econometrics
, 2008, 144(1),
156
-
74.


Frank
, Richard,

and
Richard
Zeckhauser,

Health Insurance Exchanges


Making the Markets
Work
,”

New England Journal of Medicine
,
2009, 361(12),
1135
-
1137.


Risk Adjustment

Glaze
r, Jacob and Thomas G. McGuire,
“Setting Health Plan Premiums to Ensure Efficient
Quality in Health Care: Minimum Variance Optimal Risk Adjustment,”
Journal of Public
Economics
,
2002,
84(2) 153
-
173.


Newhouse,
Joseph,
Pricing the Priceless
:

A Health Care Conundrum
. Cambridge, The MIT
Press: 2002,

53
-
59, 147
-
202.


Van de ven, Wynand P.M.M., and Randall Ellis, “Risk Adjustment in Competitive Health Plan
Markets,” in
Anthony J. Culyer and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
,
Amsterdam: North
-
Holland, 2000.



Lecture 14:
Health Care and Labor Markets


Key points:



Impact of employer
-
provided health insurance on employment and wages



Impact of public insurance on private insurance


Garthwaite, Craig,
“Economic
Benefits of Medical Innovation,” mimeo, 2009.


Gruber,
Jonathan,
“Health Insu
r
ance and the Labor Market,” in
Anthony J. Culyer and Joseph P.
Newhouse,
eds.,
Handbook of Health Economics
, Amsterdam: North
-
Holland, 2000.


Gruber
, Jonathan,
and Kosali Simon,

Crowd
-
Out Ten Years Later: Have Recent Expansi
ons of
Public Insurance Crowded Out Private Health Insurance?

Journal of Health Economics
,

2008,
27(2),
201
-
217
.


11


Meyer, Bruce, and
Dan T. Rosenbaum, “
Welfare, The Earned Income Tax Credit, and The Labor
Supply of Single Mothers,”
Quarterly Journal of
Economics
,
2001, 116(3),
1063
-
1114.


Sood, Neeraj, Arkadipta Ghosh, and Jose J. Escarce, “Employer
-
Sponsored Insurance, Health
Care C
os
t Growth, and the Economic performance of U.S. Industries,”
Heal
t
h Services
Research
,
2009, 44(5), 1449
-
1464.



Lecture 1
5
: Disability Insurance


Key points:



The enormous growth of DI



DI and employment



Optimal design of DI (and other social insurance programs)


Daron
Acemoglu

& Joshua
Angrist
,

Consequences of Employment Protection? The Case of the
A
mericans with
Disabilities Act,”

Journal of Political Economy
, 2001, 109(5), 915
-
957
.


Autor
, David

and M
ark

Duggan, “The Rise in Disability Recipiency a
nd the Decline in
Unemployment,”

Quarterly Journal of Economics
, 2003,

118(1),

157
-
206.


Bound,
John,
J
ulie Berry
Cullen, A
ustin

Nichols, and L
ucie

Schmidt, “The Welfare Implications
of Increasing Disability Insurance Benefit Generosity
,

Journal of Public Economics
, 2004,
88(12),
2487
-
2514.


Chetty, Raj, “A General Formula for the Optimal
Level

of Social Insurance,”
Journal of Public
Economics
,
2006, 90(
10
-
11)
, 1879
-
1901.


Golosov
, Michael

and A
leh

Tsyvinski, “Designing Optimal Disability Insurance: A Case for
Asset Testing
,

Journal of Political Economy
, 2006,
114(2),
257
-
279.


Gruber,
Jonathan,
“Disability Insurance

Benefits and Labor Supply
,

Journal of Political
Economy
, 2000, 108(6), 1162
-
1183.


Gruber
, Jonathan,

“The Consumption Smoothing Effects of Unemployment Insurance,”
American Economic Review
,
1997,
87(1),
192
-
205.


Krueger
, Alan

and B
ruce

Meyer, “Labor Supply Effects of Social Insurance Programs”, in A
lan

Auerbach and M
artin

Feldstein,

eds.,

Handbook of Public Economics, Volume 4
.








12


Lecture 16
: Public Insurance:
Medicare Part D


Key points:



The design and operation of
Part D



Impacts
on pharmaceutical prices
,
insurance premiums
, and outcomes



The optimality of consumer choice


Consumer Choice

Abaluck, Jason T., and Jonathan Gruber
,


Choice Inconsistencies Among the Elderly: Evidence
from Plan Choice in the Medicare Part D Program
,”

forthcoming,
American Economic Review
.


Heiss, Florian, Daniel McFadden, and Joachim Winter, “Regulation of private health insurance
markets: Lessons from enrollment, plan type choice, and adverse selection in Medicare Part D”,
NBER Working Paper No. 15392
, 2009.


Lichtenberg, Frank, and Shawn Sun, “The impact of Medicare Part D on prescription drug use by
the elderly: evidence from a large retail pharmacy chain,”

Health Affairs
,

2007,
26 (6), 1735
-
1744
.


Pharmaceutical Prices

Duggan
, Mark

and
Fiona
Scott
-
Morton
, “The Effect of Medicare Part D on Pharmaceutical
Prices and Utilization”,
American Economic Review
, 2010, 100(1): 590

607.


Darius Lakdawall
a

and Wesley Yin, “Insurer Bargaining and Negotiated Drug Prices in
Medicare Part D”,
NBER Working
Paper No. 15330, 2009.


Friedman, John
,

The Incidence of the Medicare Prescription Drug Benefit: Using Asset Prices
to Assess Its

Impact on Drug Makers
,
” mimeo, 2008.


Health Impact

Afendulis,
Christopher C.,

Yulei He,

Alan Zaslavsky,

and

Michael E. Chernew,

The Impact of
Medicare Part D on Hospitalization Rates
,


mimeo, 2010.



13


IV.
Productivity


Lectures
17&18


Key points:



The aggregate returns to health spending have been large



Cross
-
section spending differences are often not
associated with improved outcomes



Theories for the difference
:
flat of the curve medicine,
increasing returns,
general
inefficiency


Aggregate Returns to Medical Innovation

Almond, D
ouglas
,
J
oseph
J
.

Doyle Jr
.
, A
manda
E
.

Kowalski,
and Heidi
Williams,
“Estimating
Marginal Returns to Medical Care: Evidence from At
-
Risk Newborns,” NBER Working Paper
No. 14522, 2008.


Cutler, David, “Are We Finally Winning the War on Cancer?”
Journal of Economic
Perspectives
, 2008, 22(4), 3
-
26.


Cutler, David, Allison B. R
osen, and Sandeep Vijan, “Value of Medical Innovation in the United
States: 1960
-
2000,”
New England Journal of Medicine
, 2006; 355(9), 920
-
927.


Cross
-
sectional Analysis of Spending Variation

Cutler, David, and Dan Ly, “The (Paper) Work of Medicine,”
mimeo, 2011.


Doyle, J
oseph
J
.
, Jr
.
, “Returns to Local
-
Area Health Care Spending: Using Health Shocks to
Patients Far from Home,”
mimeo,
2010
.


Fisher
,

E
lliott
S
.

et al., “
The implications of regional variations in Medicare spending. Part 1: the
content,
quality, and accessibility of car
e
,


Ann
als of Internal Medicine
,

2003
,
138(4)
,
273
-
287.


Fisher
,

E
lliott
S
. et al.,


The implications of regional variations in Medicare spending. Part 2:
health outcomes and satisfaction with care
,


Ann
als of Internal
Medicine
,
2003
,
138(4)
,
288
-
298.


Skinner, Jonathan, and Doug Staiger,

Technology Diffusion and Productivity Growth in Health
C
are,” NBER Working Paper No.
14865, 2009.


Theory of Productivity Variation

Chandr
a, Amitabh and Douglas Staiger,


Productivity
Spillovers in Health Care: Evidence from
the Treatment of Heart Attacks
,”

Journal of Political Economy
,
2007,
115
(1),

103
-
140.


Garber, Alan, and Jonathan Skinner, “Is American Health Care Uniquely Inefficient?”
Journal of
Economic Perspectives
Fall 2008
22(4): 27
-
50.




14


V
.
Medical Care Markets

Lecture 19
: Physician Behavior


Key points:



Alternative
models

of physician behavior



Evidence on the supply
response to price



Thomas G. McGuire,

“Physician Agency,”
in
Anthony J. Culyer and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
,

Amsterdam: North
-
Holland, 2000 (it’s long; skim).


Frank, R
ichard and Richard
Zeckhauser, “Custom
-
made vs
.

Ready to Wear Treatments:
Behavioral Propensities in Physicians’ Choices,”
Journal of Health Economics
,
2007,
26(6)
,

1101
-
1127.


Physician Responses to Incentives

Epstein, A
rnold,

et al
.,

“The Use of Ambulatory Testing in Prepaid and Fee
-
for
-
Service Group
Practices: Relat
ion to Perceived Profitability,”

New England Journal of Medicine
,

1986,
314
(17),
1089
-
1093.


Gaynor, M
artin

and P
aul
Gertler, “Moral Hazard and Risk Spreading in Partnerships,”
Rand
Journal of Economics
,
1995,
26
(4)
, 591
-
614.


Rosenthal, Meredith,
et al., “Early Experience with Pay
-
for
-
Performance:
From Concept to
Practice,”
JAMA,
2005, 294(14),
1788
-
1793.




Lecture
20
:
The Health Care Workforce


Key points:



Physician supply: The AMA, shortages, etc.



Non
-
physician personnel

and the organization of practice


Nursing

Aiken, Linda,
et al.,

Hospital nurse staffing and patient mortality, nurse
burnout, and job
dissatisfaction
,”

JAMA
,
2002,
288(16),
1987
-
1993.


Buerhaus, Peter I., et al.,

Impact of the nurse shortage on hospital patient care: Comparative
perspectives,”

Health Affairs
, 2007, 26, 853

862.


Buerhaus
, Peter I., Douglas O. Staiger, and David I. Auerbach, “Signs of a Strengthening U.S.
Nurse Labor Market?”
Health Affairs
, 2004, W4
-
526


W4
-
533.


Needleman, Jack, et al.,
“Nurse Staffing Levels and the Quality of Care in Hospitals,”
New
England Journal of
Medicine
,
2002, 346,
1715
-
1722.


15


Physician Supply

Cooper, Richard A., Thomas E. Getzen, Heather J. McKee and Prakash Laud
,

Economic a
nd
Demographic Trends Signal
a
n Impending Physician Shortage,

Health Affairs
,
2002, 21(1),
140
-
154.


Goodman, David C.,
and Elliott Fisher, “
Physician Workforce Crisis? Wrong Diagnosis, Wrong
Prescription”,
New England Journal of Medicine
,
358(16), 1
658
-
1661.


Iglehart, John K.,

Grassroots Activism and the Pursuit

of an Expanded Physician Supply
,”
New
England Journal of
Medicine
,
2008, 358(16),
1741
-
1749.


Reyes, Jessica W.
“Gender Preference and Equilibrium in the Imperfectly Competitive Market
for Physician Services,”
Eastern Economic Journal
,
2008, 34(
3
)
,
325
-
346.


Information Technology

Brynjolfsson
,

E
ric
,
and Lor
i
n
Hitt
,


Beyond Computation: Information Technology,
Organizational Transformation and Business Performance,


Journal of Economic Perspectives
,
2000, 14(4), 23
-
48.


Masys, Daniel R., “Effects of Current and Future Information Technologies on the Health Care
Workforce,”
Health Affairs
,
2002, 21(5),
33
-
41
.



Lecture 21
:
Hospital Behavior


Key points:



The
structure of the hospital industry



Models of
not
-
for
-
profit institutions

(output maximization,
output and quality

tradeoff
,
physicians cooperative
, donor
driven
)



Empirical response to payment and information


Dranove, D
avid

and M
ark

Satterthwaite, “The Industrial Organization of Health Care Markets,”
in

Anthony J. Culyer and Joseph P. Newhouse,
eds.,
Handbook of Health Economics
,
Amsterdam: North
-
Holland,
2000.


Sloan, F
rank
, “Not
-
for
-
Profit Ownership and Hospital Behavior
,


in
Anthony J. Culyer and
Joseph P. Newhouse,
eds.,
Handbook of Health Economics
, Amsterdam: North
-
Holland, 2000.



Empirical Analysis

on the Response to Payment

Baicker, Katherine and Douglas Staiger,
“Fiscal Shenanigans, Targe
ted Federal Health Care
Funds, a
nd Patient Mortality,”
Quarterly Journal of Economics
, 2005, 120(1), 345
-
386.


Dafny, L
eemore,
“How
D
o Hospitals Respond to Price Changes?”
American Economic
Review

2005,
95: 1525
-
1547.


16


Duggan, Mark, “
Hospital Ownership and Public Medical Spending.
Quarterly Journal of
Economics
, 2000, 115(4), 1343
-
1373.


Horwitz
,
Jill,
“Making Profits and Providing Care:


Comparing Nonprofit, For
-
Profit, and
Government Hospitals,”
Health Affairs
, 2005,
23
(
3
),

790
-
801.


Empirical Analysis on the Response to Information
:
Hospital
Report Cards as an Example

Cutler, David, Robert S. Huckman,

and Mary Beth Landrum, “
The Role of Information in
Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery
,”
American
Economic Review
, 2004, 94(2), 342
-
346.


Dranove
,

D
avid
,
Dan
Kessler,
Mark McClellan
,
and Mark
Satterthwaite
, “
Is Mo
re Information
Better? The Effects
o
f `Report Cards' On Health Care Providers
,


J
ournal

of
Political Econ
omy
,

2003
,
111(3)
,
555
-
88.


Mukamel, Dana B. and
Alvin I.
Mushlin,

“An Analysis of Market Share and Price Changes After
Publication of the New York State Cardiac Surgery Mortality Reports.”
Medical Care
, 1998,
36(7), 945
-
54.


Schneider, Eric C. and Arnold M. Epstein,

“Influence of Cardiac Surgery Performance Reports
on Referral Practices and Access to Care,”
New England Journal of Medicine
, 1996, 335(4),
251
-
256.



Lecture 22
:

Competition in Health Care


Key points:



The debate about competition



Evidence on c
ompetition in different sectors: hospitals, doctors, insurers, pharmaceuticals



Antitrust issues and experience


Gaynor, M
artin

and W
illiam

Vogt, “Antitrust and Competition in Health Care Markets,”
in
Anthony J. Culyer and Joseph P. Newhouse,
eds.,
Handboo
k of Health Economics
, Amsterdam:
North
-
Holland, 2000.


Hospital Competition

Barro, Jason, Robe
rt Huckman, and Daniel Kessler,
“The Effects of Specialty Hospitals on the
Cost and Quality of Medical Care,”
Journal of Health Economics
,
2005,
25
(4)
,

702
-
721.


Cutler
, David,

Robert S. Huckman, and
Jonathan T. Kolstad,


Input Constraints and the
Efficiency of Entry: Lessons from Cardiac Surgery
,”
American Economic Journal: Economic
Policy
,
2010,

2(1), 51
-
76
.

Huckman, Robert S.
,


Hospital Integration and

Vertical Consolidation: An Analysis of
Acquisitions in New York State
,”

Journal of Health Economics,

2006,

25(1), 58
-
80.


17


Kessler, Daniel and Mark McClellan
,

“Is Hospital Competition Socially Wasteful?”
Quarterly
Journal of Economics
,
2000, 115(2),
577
-
615.


Insurer Competition

Dafny, Leemore, “
Are
Health Insurance Markets

Competitive?

American Economic Review,
2010, 100(4),
1399
-
1431.



Lecture 23
: Medical Malpractice


Key Points:



How malpractice works



Evidence on the optimality of medical
malpractice



Defensive medicine


Brennan, Troy, et al.,

Incidence of adverse events and negligence in hospitalized patients.
Results of the Harvard Medical Practice Study I
,”
New England Journal of
Medicine
,
1991
,
324(6),
370
-
376.


Baicker, Katherine, Elliott S. Fisher, and Amitabh Chandra. "Malpractice Liability Costs and the
Practice of Medicine in the Medicare Program."
Health Affairs

2007,
26
(3),

841
-
852.


Dubay
,

L
isa
,
Robert Kaestner
,
and Tim Waidmann
,

The Impact of
Malpractice Fears on
Cesarean Section Rates,


Journal of Health Economics
,
1999, 18(4),

491

522.


Kessler, Daniel,
and Mark McClellan, “Do Doctors Practice Defensive Medicine,”
Quarterly
Journal of Economics,
1996,
111(2), 353
-
390.


Mello, Michelle, et al., “National Costs of the
Medical Liability System,”
Health Affairs
,
2010,
29(
9
),
1569
-
1577.


Studdert, David,
et al.,

Claims, Errors, and Compensation Payments in Medical Malpractice
Litigation
,”
N
ew England Journal of Medicine
,
2006,
354(19), 2024
-
2033.



Lecture 2
4
:
The Life Cycle of Technology


Key Points:



The technology process: discovery, approval, reimbursement



The diffusion of technology



Aggregate impacts of technology


Discovery

Heidi William
s, “
Intellectual Property
Rights and Innovation: Evidence from the Human
Genome
,” mimeo, 2009.


18


The FDA

Carpenter, Daniel,

Groups, the Media, Agency Waiting Costs, and FDA Drug Approval,


American Journal of Political Science
,
2002,
46(3)
,

490
-
505.


Reimbursement

Keenan, P
atricia
S.,
Peter J.
Neumann, and
Kathryn A.
Phillips,


Biotechnology and Medicare
New Technology Policy: Lessons from 3 Case Studies
,”

Health Affairs
,

2006,
25(5)
, 1260
-
1269.


Diffusion

Cutler, David, and Robert Huckman, “
Technological Development and Medical
Productivity:
The Diffusion of Angioplasty in New York State,”

Journal of Health Economics
, 2003, 22(2),
187
-
217.


Newhouse, Joseph P.,

Medical Care Costs: How Much Welfare Loss?

Journal of Economic
Perspectives,

1992,
6(3), 13
-
29
.


Overall Impact

Chandra, Amitabh, and Jonathan Skinner, “Technology Growth and Expenditure Growth in
Health Care,”
mimeo, 2009.


Cutler, David, and Mark McClellan, “
Is Technological Change in Medicine Worth It?”
Health
Affairs
,
2001,
20(5),
11
-
29.


Lichtenberg, Frank,
“The Impact of New Drugs on U.S. Longevity and Medical Expenditure,
1990
-
2003,”

American Economic Review
,

2007,
97(2), 438
-
443.


Newhouse, Joseph P., “
Medical Care Costs: How Much Welfare Loss?

Journal of Economic
Perspectives,

1992,
6(3), 13
-
29.