Medicare helps protect the elderly against catastrophic medical expenditure risk. Increasing the Eligibility age will expose many to higher costs and financial strain.

More than half of all lifetime medical expenses are incurred after 65; Medicaid protects seniors from the financial strain which would normally be associated with these costs. In new research, Silvia Helena Barcellos and Mireille Jacobson find that Medicare reduces the fraction of the elderly whose out-of-pocket medical costs exceed their income from 9 to 5 percent, and also reduces recipients’ medically related financial stress by as much as one third. In light of these findings, they argue that recent proposals to increase the Medicare Eligibility age will substantially increase the risk of catastrophic medical expenditures for those who would no longer be covered

Aftershocks: The Impact of Clinic Violence on Abortion Services

Between 1973 and 2003, abortion providers in the United States were the targets of over 300 acts of extreme violence. Using unique data on attacks and on abortions, abortion providers, and births, we examine how anti-abortion violence has affected providers’ decisions to perform abortions and women’s decisions about whether and where to terminate a pregnancy. We find that clinic violence reduces abortion services in targeted areas. Once travel is taken into account, however, the overall effect of the violence is much smaller.

Beyond Incentives: Do Schools use Accountability Rewards Productively?

"Accountability mandates" -- the explicit linking of school funding, resources, and autonomy to student performance on standardized exams -- have proliferated in the last 10 years. In this paper, we examine California's accountability system, which for several years financially rewarded schools based on a deterministic function of test scores. The sharp discontinuity in the assignment rule -- schools that barely missed their target received no funding -- generates "as good as random" assignment of awards for schools near their eligibility threshold and enables us to estimate the (local average) treatment effect of California's financial award program. This design allows us to explore an understudied aspect of accountability systems -- how schools use their financial rewards. Our findings indicate that California's accountability system significantly increased resources allocated to some schools. In the 2000 school year, the average value of the award was about 60 dollars per student and 50 dollars in 2001. Moreover, we find that the total resources flowing to districts with schools that received awards increased more than dollar for dollar. This resource shift was greatest for districts with schools that qualified for awards in the 2000 school year,the first year of the program, increasing total per pupil revenues by roughly 5 percent. Despite the increase in revenues, we find no evidence that these resources increased student achievement. Schools that won awards did not purchase more instructional material, such as computers, which may be inputs into achievement. Although the awards were likely paid out as teacher bonuses, we cannot detect any effect of these bonuses on test scores or other measures of achievement. More worrisome, we also find a practical effect of assigning the award based in part on the performance of "numerically significant subgroups" within a school was to reduce the relative resources of schools attended by traditionally disadvantaged students.

How Costly Is Hospital Quality? A Revealed-Preference Approach

Abstract We analyze the cost of quality improvement in hospitals, dealing with two challenges. Hospital quality is multidimensional and hard to measure, while unobserved productivity may in ‡uence quality supply. We infer the quality of hospitals in Los Angeles from patient choices. We then incorporate 'revealed quality' into a cost function, instrumenting with hospital demand. We …nd that revealed quality di¤erentiates hospitals, but is not strongly correlated with clinical quality. Revealed quality is quite costly, and tends to increase with hospital productivity. Thus, non-clinical aspects of the hospital experience (perhaps including patient amenities) play important roles in hospital demand, competition, and costs. We wish to than

Going to Pot? The Impact of Dispensary Closures on Crime.

Jurisdictions that sanction medical or, more recently, recreational marijuana use often allow retail sales at dispensaries. Dispensaries are controversial as many believe they contribute to local crime. To assess this claim, we analyze the short-term mass closing of hundreds of medical marijuana dispensaries in Los Angeles. Contrary to popular wisdom, we find an immediate increase in crime around dispensaries ordered to close relative to those allowed to remain open. The increase is specific to the type of crime most plausibly deterred by bystanders, and is correlated with neighborhood walkability. We find a similar pattern of results for temporary restaurant closures due to health code violations. A likely common mechanism is that "eyes upon the street" deter some types of crime