This paper examines the effect of robots on workplace injury benefits paid in South Korea. Using the administrative data on worker's compensation, I found that the increase in robot exposure contributes to the significant decline in the average benefit amount per covered worker, mainly driven by the reduction in the number of claims, rather than the size of claims. The effects are stronger, especially for serious cases such as permanent disability.
Policymakers increasingly implement pay-for-performance schemes to incentivize quality of care. A key design issue when incentivizing several process measures of quality relates to whether the payment should be linked to the performance on each measure or whether the payment should be conditional on all of the process measures of quality being provided, which we refer to as “care bundling”. After developing a theoretical framework of provider incentives under care bundling, we employ a difference-in-difference analysis to evaluate the Best Practice Tariff for fragility hip fracture, introduced in England in 2010, which rewards providers based on a care bundle of nine process measures that need to be jointly achieved. The design of the processes was evidence-based and the size of the bonus was significant, up to 20% of the baseline tariff. The results suggest that the policy was successful in increasing the proportion of patients for whom all of the criteria are met by 52.5 percentage points in the first 5 years after its introduction. Temporal ordering of processes might matter under care bundling, but we do not find evidence that English providers exerted less effort to meet process measures if they already failed to meet an earlier one. Overall, we find that a scheme based on care bundle, which is evidence based and uses a sizable bonus, can be effective in improving hospital performance.
This article examines the Online Elicitation of Personal Utility Functions (OPUF) method as a novel approach for health state valuation. While OPUF offers a structured, modular alternative to traditional methods, it also presents notable challenges. Chief among these is its reliance on compositional trade-offs between health dimensions (e.g., pain, mobility, anxiety), which may inadequately reflect how individuals experience health holistically. Additionally, OPUF's use of numerical rating scales does not guarantee that resulting utility values exhibit interval properties—a requirement for robust interpretation in economic evaluations. To contextualize OPUF within the broader landscape of valuation methods, this article introduces a classification scheme outlining alternative approaches and their respective trade-offs in terms of precision, cognitive burden, and feasibility.
Competition between firms selling similar drugs is often fostered by policymakers as a means to curb pharmaceutical spending. While firms may compete within these specific drug markets, they also repeatedly encounter rival firms in different markets. This may shape competitive dynamics within and between markets. Yet, multimarket contacts, particularly relevant for multiproduct firms such as pharmaceutical companies, are often overlooked by pricing regulations. This paper investigates how multimarket contacts influence competition between pharmaceutical firms in off-patent markets. Using detailed product-level information on all retail pharmacy sales of generic statin drugs, we quantify the universe of multimarket contacts between firms in these off-patent markets, in Portugal, between 2015 and 2017. We then assess how multimarket contacts affect price competition. To do so, we explore the strict price regulation in Portuguese generic drug markets. Specifically, the Portuguese Internal Reference Pricing System (RPS) defines a price cap for each generic drug. Rather than examining absolute drug prices, we quantify the degree of price competition as the ratio between a firm's drug price and its regulatory price cap (price-to-cap ratio). We find that firms with more multimarket interactions set prices closer to price caps, consistent with the mutual forbearance hypothesis. This effect persists after controlling for brand status, lagged market share, and is not explained by common ownership. Our main results are consistent across alternative model specifications. However, due to limited within-firm variation over time, the effect is not significant in system generalized method of moment instrumental variable estimates. These results suggest that price caps may act as coordination anchors, thus lowering price competition between firms. Policymakers should consider targeted price cap adjustments as safeguards to preserve competition in off-patent drug markets.
Long-term care (LTC) provides essential support to service users and informal carers to improve their quality of life. By improving quality of life, LTC can potentially impact economic growth, for example, it may enable service users of working age and their carers to spend more time in paid employment. This study investigates the effect of publicly-funded LTC expenditure on a measure of paid production across local authorities in England. We analyze yearly data from 2014/15 to 2019/20 using a dynamic panel model estimated by the Arellano-Bond estimator. We find that a £1000 increase in LTC expenditure per client increases paid production per capita by £216 in the short run and by £670 in the long run. These findings may inform policy makers interested in assessing the financial sustainability of LTC policies.
The association between unemployment and health is well documented, but causality remains unclear. This paper investigates how pre-existing health conditions amplify the effects of adverse labor market shocks. Using variation in local unemployment generated by a shock in the petroleum prices that hit the geographic center of the petroleum industry in Norway, but left other regions more or less unaffected, our study reveals that workers with compromised health face a higher likelihood of unemployment during downturns. Heterogeneity analysis reveals differences in susceptibility based on gender, age, education, and job type. Females exhibit greater sensitivity to health, and the youngest age group is most affected. Furthermore, higher education and white-collar jobs correlate with amplified health-related unemployment effects. Conversely, poor health in combination with high age, low education, and blue-collar jobs increases the uptake of social insurance during the economic downturn, pointing toward the substitutability between unemployment benefits and health-related benefits.
This paper studies how ecological fiscal transfers (EFT) can affect child health by exploiting a county-level panel dataset, using variation across counties and over time in the implementation of EFT policy in China. Our estimates indicate that EFT leads to a significant decline of 0.121 in the under-five mortality rates. Notably, EFT can increase three types of public expenditures, environmental protection, social security and healthcare, due to the flypaper effect. It results in reducing air pollution, increasing rural residents' income and improving the supply of health care service, and causes the decrease of mortality rates. The health effect of EFT is more significant in counties with steep slope, high fiscal pressure and weak clan culture.
This paper examines the role of insurer size in price negotiations between commercial health insurers and hospitals in the United States. The empirical analysis focuses on a dominant insurer in the Arkansas individual health insurance market that experienced a size increase due to a policy change. Under the Affordable Care Act (ACA), Arkansas expanded its Medicaid program, but unlike other expansion states, it used individual plans—a private insurance option generally not designed for Medicaid—to provide coverage to newly insured beneficiaries. This unique policy nearly doubled the insurer's individual plan enrollment after the ACA was implemented. Admission-level regression analysis reveals that the insurer's hospital inpatient prices for individual plans decreased by 16.7% following the expansion. Consistent with the predictions from bargaining models, the findings suggest that the insurer's increased bargaining leverage due to its larger size is the primary mechanism behind the price reduction.
To promote the evaluation of existing long-term care (LTC) policies and the involvement of the scientific community in future LTC policymaking, the Gateway to Global Aging Data project organized a conference in November 2023. This LTC Policy Virtual Special Issue features eight papers from this conference that were invited to undergo further blind peer review prior to publication in Health Economics. This introduction to the LTC Policy Virtual Special Issue provides a summary of each article, briefly covering the research question, conceptualization of the problem, approach used, methodological challenges, key outcomes and findings, and implications for policy and future research.
This study experimentally tests the impact of providing information about vaccine safety and efficacy delivered by Black health care professionals. We find that providing general information increases vaccination rates after 5 months by 8 percentage points (17%), driven by a 9.8 pp (24%) increase among white participants. Political affiliation emerges as a key moderator to explain this discordant effect. Across race, general information is more effective for politically moderate and conservative respondents, most of whom are white. Among this most vaccine-hesitant group, the information effectively addresses concerns about both side effects and unknown long-run effects due to the fast approval of the vaccine, increasing vaccination rates by 14 pp.
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