28 research outputs found

    Review Of Finance And The Good Society By R.J. Shiller

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    Does Increased Access to Health Insurance Impact Claims for Workers\u27 Compensation? Evidence from Massachusetts Health Care Reform

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    We study over 20 million emergency room (ER) discharges in Massachusetts and three comparison states to estimate the impact of Massachusetts health care reform on claims for Workers’ Compensation (WC). Prior evidence on the relationship between health insurance and WC claiming behavior is mixed. We find that the reform caused a significant decrease in the number of per-capita ER discharges billed to WC. This result is driven by larger decreases in WC discharges for conditions for which there is greater scope to change the payer or the location of care. Conversely, we estimate smaller impacts for weekend versus weekday admissions and for wounds compared to musculoskeletal injuries. Our findings are consistent with the reform lowering WC medical costs for employers/insurers, primarily by inducing injured workers to seek care at less costly sites. The results suggest much smaller impacts on the propensity to bill WC for a given injury

    Local Food Prices And The Purchasing Power Of SNAP Benefits

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    While the nominal value of Supplemental Nutrition Assistance Program (SNAP) benefits is fixed across states (except for Hawaii and Alaska), variation in food prices across the U.S. is dramatic. We provide new evidence describing geographic variation in the purchasing power of SNAP benefits, measured by the extent to which SNAP-recipient households are able to afford the Thrifty Food Plan (TFP), the U.S. Department of Agriculture (USDA) food plan on which legislated SNAP benefit levels are based. For more than one-quarter of SNAP households, SNAP benefits are too low to cover the cost of the TFP at the primary stores where they report shopping. SNAP purchasing power increases somewhat as we assume households can travel farther to shop and increases much more with the assumed ability to identify and travel to the lowest-cost store in a given area. It is unlikely, however, that SNAP households are sufficiently informed and mobile to shop at the lowest-cost store in a large (e.g., 10 to 20-mile) geographic area. We demonstrate that aggregate dollar shortfalls for SNAP households who cannot afford the TFP could be completely eliminated by redistributing from households in low-cost areas to those in high-cost areas, e.g., by indexing SNAP benefits to local food prices

    Involuntary And Patient-Initiated Delays In Medical Care During The COVID-19 Pandemic

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    This paper uses data from a new, nationally representative survey to study delays in non–COVID-related medical care among US adults during the COVID-19 pandemic. We expand on prior research by taking a comprehensive look at the many reasons patients may have experienced delays in medical care and by studying the longer-run implications of these delays for patients’ self-reported health, use of telemedicine, feelings of regret, and likelihood of delaying care again in the future. Classifying delays in care broadly as involuntary (those due to availability or “supply-side” constraints) or patient-initiated (those due to patient concerns or “demand-side” constraints), we document important differences across demographic groups in the propensity to delay care for these reasons. In contrast to most prior work on this topic, our analyses can disentangle differences in the likelihood of delaying care from differences in pre-pandemic care-seeking behavior. We also demonstrate that the types of medical care that were delayed during the pandemic differed based on whether the delay was involuntary or patient-initiated, as did the duration of the delays and their associations with self-reported health, telemedicine use, and feelings of regret

    Diagnosing The Learning Environment For Diverse Students In Introductory Economics: An Analysis Of Relevance, Belonging, And Growth Mindsets

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    Using administrative and survey data, we diagnose the learning environment in an introductory economics course. Relative to men from overrepresented groups, women and underrepresented minority students finish the course reporting significantly lower measures of relevance, belonging, and growth mindsets, factors related to college success. For example, they are less likely to agree that their professor used relatable examples, more likely to report feeling different than the typical economics major, and less likely to report believing they could learn the material. We also describe a new, low-cost initiative expanding the role of undergraduate teaching assistants to promote a more inclusive environment

    When a Nudge Isn’t Enough: Defaults and Saving Among Low-Income Tax Filers

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    Recent evidence suggests that the default options implicit in economic choices (e.g., 401(k) savings by white-collar workers) have extraordinarily large effects on decision-making. This study presents a field experiment that evaluates the effect of defaults on savings among a highly policy-relevant population: low-income tax filers. In the control condition, tax filers could choose (i.e., opt in) to receive some of their federal tax refund in the form of U.S. Savings Bonds. In the treatment condition, a fraction of the tax refund was automatically directed to U.S. Savings Bonds unless tax filers actively chose another allocation. We find that the opt-out default had no impact on savings behavior. Furthermore, our treatment estimate is sufficiently precise to reject effects as small as one-fifth of the participation effects found in the 401(k) literature. Ancillary evidence suggests that this "nudge" was ineffective in part because the low-income tax filers in our study had targeted plans to spend their refunds. These results suggest that choice architecture based on defaults may be less effective in certain policy-relevant settings, particularly where intentions are strong.

    Impacts of Public Insurance on Health Outcomes for Children in Immigrant Families

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    Children in immigrant families are one of the fastest-growing segments of the U.S. population and are disproportionately represented among the poor and uninsured. Rules regarding their eligibility for public health insurance have changed substantially over the past 15 years, yet little is known about the impacts of such changes on these children's health or access to care. Assistant Professor of Economics Erin Todd Bronchetti discusses her research, which uses data from the National Health Interview Survey (NHIS) and variation in state Medicaid/SCHIP laws to answer this question, providing some of the first estimates of the impacts of public insurance on health outcomes and health care utilization for children in immigrant families

    Public Insurance Expansions And The Health Of Immigrant And Native Children

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    The costs of public insurance expansions are ordinarily justified by the claim that increased eligibility causes gains in insurance coverage, which translate into improved health care and health. This paper studies dramatic changes in public health insurance eligibility for immigrant and native children from 1998 to 2009 and finds that children\u27s nativity status is crucial to understanding the impacts of recent eligibility expansions. I document a significantly higher degree of take-up (and less crowding out of private insurance) among first- and second-generation immigrant children than among children of U.S. natives. Eligibility expansions increased immigrant children\u27s use of preventive and ambulatory care and decreased emergency care in hospitals, while estimated effects for children of natives are negligible. My results also suggest improvements in some health measures that would be expected to respond to preventive and ambulatory care

    Workers\u27 Compensation And Consumption Smoothing

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