Initial Wage, Human Capital and Post Wage Differentials

Insufficiency in information with which firms judge the productivity of a worker for the first time in the market creates more randomness in initial wages than in later wages. This paper examines whether the initial randomness in wages may have a persistent effecton post wages. We set up a human capital accumulation in which an individual may respond to the positive error in initial wage by adjusting hours worked thereafter in her career, and consequently may receive higher future wages than those who draw a negative error in initial wages but otherwise are equivalent. The model predicts that the initial wage, in particular, its random component, is a persistently important factor having positive effecton future wages. Using data from the National Longitudinal Survey of Youth 79, we find empirical evidence that this effect is indeed positive and persists even after 20 years since the initial entry to labor market. The decomposition of initial wages by both parametric and nonparametric IV methods further shows that this effectis derived by the random component, nott he observable component, of the initial wage. It implies that the observed cross-sectional wage variation within group can be accounted for the initial randomness in wages.Human Capital Accumulation, Learning, Initial Wage, Wage Differentials

Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis

BACKGROUND: Medicare-Medicaid dual eligibles are the beneficiaries of both Medicare and Medicaid. Dual eligibles satisfy the eligibility conditions for Medicare benefit. Dual eligibles also qualify for Medicaid because they are aged, blind, or disabled and meet the income and asset requirements for receiving Supplement Security Income (SSI) assistance. The objective of this study is to explore the relationship between dual eligibility and health care utilization among Medicare beneficiaries. METHODS: The household component of the nationally representative Medical Expenditure Panel Survey (MEPS) 1996–2000 is used for the analysis. Total 8,262 Medicare beneficiaries are selected from the MEPS data. The Medicare beneficiary sample includes individuals who are covered by Medicare and do not have private health insurance during a given year. Zero-inflated negative binomial (ZINB) regression model is used to analyse the count data regarding health care utilization: office-based physician visits, hospital inpatient nights, agency-sponsored home health provider days, and total dental visits. RESULTS: Dual eligibility is positively correlated with the likelihood of using hospital inpatient care and agency-sponsored home health services and the frequency of agency-sponsored home health days. Frequency of dental visits is inversely associated with dual eligibility. With respect to racial differences, dually eligible Afro-Americans use more office-based physician and dental services than white duals. Asian duals use more home health services than white duals at the 5% statistical significance level. The dual eligibility programs seem particularly beneficial to Afro-American duals. CONCLUSION: Dual eligibility has varied impact on health care utilization across service types. More utilization of home healthcare among dual eligibles appears to be the result of delayed realization of their unmet healthcare needs under the traditional Medicare-only program rather than the result of overutilization in response to the expanded benefits of the dual eligibility program. The dual eligibility program is particularly beneficial to Asian and Afro-American duals in association with the provision of home healthcare and dental benefits

Private health insurance in South Korea: An international comparison

Objectives: The goal of this study is to present the historical and policy background of the expansion of private health insurance in South Korea in the context of the National Health Insurance (NHI) system, and to provide empirical evidence on whether the increased role of private health insurance may counterbalance government financing, social security contributions, out-of-pocket payments, and help stabilize total health care spending. Methods: Using OECD Health Data 2011, we used a fixed effects model estimation. In this model, we allow error terms to be serially correlated over time in order to capture the association of private health insurance financing with three other components of health care financing and total health care spending. Results: The descriptive observation of the South Korean health care financing shows that social security contributions are relatively limited in South Korea, implying that high out-of-pocket payments may be alleviated through the enhancement of NHI benefit coverage and an increase in social security contributions. Estimation results confirm that private health insurance financing is unlikely to reduce government spending on health care and social security contributions. We find evidence that out-of-pocket payments may be offset by private health insurance financing, but to a limited degree. Private health insurance financing is found to have a statistically significant positive association with total spending on health care. This indicates that the duplicated coverage effect on service demand may cancel out the potential efficiency gain from market initiatives driven by the active involvement of private health insurance. Conclusions: This study finds little evidence for the benefit of private insurance initiatives in coping with the fiscal challenges of the South Korean NHI program. Further studies on the managerial interplay among public and private insurers and on behavioral responses of providers and patients to a given structure of private-public financing are warranted to formulate the adequate balance between private health insurance and publicly funded universal coverage. (C) 2012 Elsevier Ireland Ltd. All rights reserved.1

Fertility, Relative Wages, and Labor Market Decisions: A Case of Female Teachers

This paper examines the effects of fertility and relative wages on occupational choice (teaching versus non-teaching) and labor force participation decisions of female college graduates using selectivity-corrected panel estimations. We find that the presence of a new born baby is not particularly important to the choice of occupation, but significantly discourages female labor force participation, especially among teachers. Higher relative wages are found to effectively attract female college graduates into teaching. College major in education is one of the most relevant determinants for female college graduates to become teachers. Though investing educational expenditures on teachers' salary seems to be a valid policy, providing incentives for female college students to major in education will be an alterative way to secure teacher supply. (c) 2005 Elsevier Ltd. All rights reserved.1

Quality of Care and Role of Health Insurance Among Non-elderly Women with Disabilities

Objectives. We examined differences in the quality of health care provided by usual source of care providers between women with and without disabilities in the United States. The role of health insurance in ensuring equitable quality of care for women with disabilities was investigated. Methods. A national sample of 12,199 women aged 18-64 was drawn from the 2002 Medical Expenditure Panel Survey. Descriptive and multivariate analyses were performed to investigate the interactive associations of disability and insurance coverage with accessibility, satisfaction and adequacy of care among women. Results. Compared with women without disabilities, women with disabilities were more likely to experience lower quality of care in terms of accessibility of care, satisfaction with care, and adequate receipt of care. This diminished quality of care for women with disabilities was alleviated, but only to a limited extent, by health insurance coverage. A significant difference remained in the quality of care between the 2 insured subgroups. Conclusions. Having health insurance was strongly associated with improved access to care and reduced unmet or delayed care among women with disabilities in the United States. In addition to an expansion of public insurance program eligibility, the quality of care provided under the public insurance system needs to be ensured to maximize appropriate and timely care for women with disabilities.1

Do HMO Plans Reduce Health Care Expenditure in the Private Sector?

The cost containment performance of health maintenance organization (HMO) plans relative to non-HMOs is examined using data from the 2000 Medical Expenditure Panel Survey. When various compounding factors are controlled for, among the privately insured, nonelderly population, HMO enrollment is found to contain neither total health care spending nor total insurance payment, though it reduces total out-of-pocket expenditure. We further find that this result is not attributed to selectivity in health plan choice due to health risk. The favorable cost sharing for enrollees and the distinct reimbursement schemes in HMO plans seem to account for no significant overall cost saving.1