Structural Estimation with a Randomized Trial of a Principal Agent Model of Medical Insurance with Moral Hazard

Despite the importance of principal-agent models in the development of modern economic theory, there are few estimations of these models. We contribute to fill this gap in a field where moral hazard has traditionally been considered important: the utilization of health care services. This paper presents a model where the individual decides to have treatment or not when she suffers an illness spell. The decision is taken on the basis of comparing benefits and out-of-pocket monetary costs of treatment. In the paper, we recover the estimates of the corresponding principal agent model and obtain an approximation to the optimal contract.

COUNTS WITH AN ENDOGENOUS BINARY REGRESSOR: A SERIES EXPANSION APPROACH

We propose an estimator for count data regression models where a binary regressor is endogenously determined. This estimator departs from previous approaches by using a flexible form for the conditional probability function of the counts. Using a Monte Carlo experiment we show that our estimator improves the fit and provides a more reliable estimate of the impact of regressors on the count when compared to alternatives which do restrict the mean to be linear-exponential. In an application to the number of trips by households in the US, we find that the estimate of the treatment effect obtained is considerably different from the one obtained under a linear-exponential mean specification.Count data, Polynominal Poisson Expansions, Flexible Functional Form.

Quality Externalities among Hotel Establishments: What is the Impact of Tour Operators

This paper is about quality decisions in a vertical structure where competitive producers sell to powerful retailers. Specifically, we focus the analysis on the role played by a tour operator on quality investments when distributing the capacity of a given tourist destination. We emphasize the presence of quality externalities among hotel establishments, and see that sometimes a Tour Operator distribution can provide a solution to the "tragedy of the commons' in quality provision. Thus, we analyze what implications do vertical relations have for quality in this industry, and then derive some policy recommendationsvertical relations, externalities, tragedy of commons,tourism, hotel industry

Are tax subsidies for private medical insurance self-financing? Evidence from a microsimulation model for outpatient and inpatient episodes

This paper analyses whether or not tax subsidies to private medical insurance are self-financing by means of a structural approach. We construct a simulation routine based on a microeconometric discrete choice model that allows us to evaluate the impact of premium changes on the utilisation of outpatient and inpatient health care services. We simulate the 1999 Spanish tax reform that abolished the tax deduction for expenditures on private health insurance using a representative sample of the Catalan population. Prior to this reform, foregone tax revenue arising from deductions after the purchase of private insurance amounted to €69.2 M. per year. In contrast, the elimination of the subsidies to private policies is estimated to generate an extra cost for the public sector of about €8.9 M. per year.Health care utilisation, structural modelling, tax reform evaluation

The impact of the American Civil War on city growth

This paper analyzes the persistence of the shock caused by the American Civil War on the relative city size distribution of the United States. Our fi�ndings suggest that the effects of this shock were permanent, which sharply contrasts with previous results regarding World War II for Japanese and German cities. It should be taken into account that the conflict considered in this paper took place at an earlier stage of the industrialization and urbanization processes. Moreover, our results are determined by the fact that the battles were fought in the open �field, not in urban areas. Some related evidence regarding the presence of a safe harbour effect is reported.

How complex are the contracts offered by health plans?

Financial support by a Marie Curie Fellowship under contract no. HPMF-CT-01206. Olivella acknowledges financial support from projects SEJ2006-00538, ECO2009-7616, Consolider-Ingenio CSD2006-16, 2009SGR-169, and Barcelona Economics-Xarxa CREA. Olivella is a Research Fellow of MOVE (Markets, Organizations and Votes in Economics)When health plans compete under adverse selection, the competitive equilibrium set of contracts is unique. However, the allocation of these contracts among health plans is undetermined. We show that three health plans suffice to sustain an equilibrium where each health plan offers a single contract and attracts a single type of agent (full specialization). We also show that this equilibrium can be ruled out by introducing any horizontal differentiation, and that if in equilibrium each health plan attracts all types of agents, at least one of the health plans must do so through a menu of contracts

Per què adquirir una assegurança de salut privada?

Per què algunes persones compren assegurances de salut privades quan ja existeix un sistema nacional de salut públic i gratuït? Aquest article desenvolupa un model teòric i contrasta empíricament la seva predicció principal emprant dades del Regne Unit. El model prediu que si les persones tenen millor informació que les asseguradores sobre el seu propi estat de salut o sobre les seves preferències per a la salut, les persones més propenses a utilitzar els serveis sanitaris compraran una assegurança privada, mentre que la resta optarà per usar els serveis del sistema nacional de salut. Sorprenentment, el que determina aquestes decisions són les preferències per la salut.Por qué algunas personas compran seguros de salud privados cuando ya existe un sistema nacional de salud público y gratuito? Este artículo desarrolla un modelo teórico y contrasta su predicción principal con datos del Reino Unido. El modelo predice que si las personas tienen mejor información que las aseguradoras sobre su propio estado de salud o sobre sus preferencias, entonces las más propensas a utilizar los servicios sanitarios comprarán un seguro privado, mientras que el resto optará por usar los servicios del sistema nacional de salud. Sorprendentemente, lo que determina estas decisiones son las preferencias por la salud.Why do some people buy private health insurance when there is a national system of free health services? This article develops a theoretical model and tests its main prediction with data from the UK. The model predicts that if people have better information than insurers about their own health or preferences then those more likely to use health services will buy private insurance, while the rest will use the services of the national health system. Surprisingly, it is the preference for health what drives these decisions

The Two-Dimensional, Rectangular, Guillotineable-Layout Cutting Problem with a Single Defect

In this paper, a two-dimensional cutting problem is considered in which a single plate (large object) has to be cut down into a set of small items of maximal value. As opposed to standard cutting problems, the large object contains a defect, which must not be covered by a small item. The problem is represented by means of an AND/OR-graph, and a Branch & Bound procedure (including heuristic modifications for speeding up the search process) is introduced for its exact solution. The proposed method is evaluated in a series of numerical experiments that are run on problem instances taken from the literature, as well as on randomly generated instances.Two-dimensional cutting, defect, AND/OR-graph, Branch & Bound