Audits are generally intended to monitor compliance with existing rules. However, audits can also create unintended impacts and incentives through the specific protocol by which they are executed. In particular, audits can discourage the use of complex administrative procedures with more rules for auditors to check. This paper investigates the effects of procurement audits on public entities' choice of purchase procedures in Chile. While the national procurement legislation tries to promote the use of more transparent and competitive auctions rather than discretionary direct contracts for selection of suppliers, auctions are significantly more complex and the audit protocol mechanically leads to more scrutiny and a higher probability of further investigation for auctions than for direct contracts. Using a regression discontinuity design based on a scoring rule of the National Comptroller Agency, we find that audits lead to a decrease in the use of auctions and a corresponding increase in the use of direct contracts. In order to further test the underlying mechanism, we develop a new approach to conduct subgroup analysis in regression discontinuity designs while holding other observables constant.
{"title":"Can Audits Backfire? Evidence from Public Procurement in Chile","authors":"M. Gerardino, S. Litschig, D. Pomeranz","doi":"10.3386/W23978","DOIUrl":"https://doi.org/10.3386/W23978","url":null,"abstract":"Audits are generally intended to monitor compliance with existing rules. However, audits can also create unintended impacts and incentives through the specific protocol by which they are executed. In particular, audits can discourage the use of complex administrative procedures with more rules for auditors to check. This paper investigates the effects of procurement audits on public entities' choice of purchase procedures in Chile. While the national procurement legislation tries to promote the use of more transparent and competitive auctions rather than discretionary direct contracts for selection of suppliers, auctions are significantly more complex and the audit protocol mechanically leads to more scrutiny and a higher probability of further investigation for auctions than for direct contracts. Using a regression discontinuity design based on a scoring rule of the National Comptroller Agency, we find that audits lead to a decrease in the use of auctions and a corresponding increase in the use of direct contracts. In order to further test the underlying mechanism, we develop a new approach to conduct subgroup analysis in regression discontinuity designs while holding other observables constant.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87300612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Voter mobilization campaigns face trade-offs in young democracies. In a large-scale experiment implemented in 2013 with the Kenyan Electoral Commission (IEBC), text messages intended to mobilize voters boosted participation but also decreased trust in electoral institutions after the election, a decrease that was stronger in areas that experienced election-related violence, and for individuals on the losing side of the election. The mobilization backfired because the IEBC promised an electronic voting system that failed, resulting in manual voting and tallying delays. Using a simple model, we show signaling high institutional capacity via a mobilization campaign can negatively affect beliefs about the fairness of the election.
{"title":"The Perils of Voter Mobilization","authors":"Benjamin M. Marx, V. Pons, T. Suri","doi":"10.3386/w23946","DOIUrl":"https://doi.org/10.3386/w23946","url":null,"abstract":"Voter mobilization campaigns face trade-offs in young democracies. In a large-scale experiment implemented in 2013 with the Kenyan Electoral Commission (IEBC), text messages intended to mobilize voters boosted participation but also decreased trust in electoral institutions after the election, a decrease that was stronger in areas that experienced election-related violence, and for individuals on the losing side of the election. The mobilization backfired because the IEBC promised an electronic voting system that failed, resulting in manual voting and tallying delays. Using a simple model, we show signaling high institutional capacity via a mobilization campaign can negatively affect beliefs about the fairness of the election.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"150 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72684940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
External validity is a fundamental challenge in treatment effect estimation. Even when researchers credibly identify average treatment effects – for example through randomized experiments – the results may not extrapolate to the population of interest for a given policy question. If the population and sample differ only in the distribution of observed variables this problem has a well-known solution: reweight the sample to match the population. In many cases, however, the population and sample differ along dimensions unobserved by the researcher. We provide a tractable framework for thinking about external validity in such cases. Our approach relies on the fact that when the sample is drawn from the same support as the population of interest there exist weights which, if known, would allow us to reweight the sample to match the population. These weights are larger in a stochastic sense when the sample is more selected, and their correlation with a given variable reflects the intensity of selection along this dimension. We suggest natural benchmarks for assessing external validity, discuss implementation, and apply our results to data from several recent experiments.
{"title":"Weighting for External Validity","authors":"Isaiah Andrews, E. Oster","doi":"10.3386/W23826","DOIUrl":"https://doi.org/10.3386/W23826","url":null,"abstract":"External validity is a fundamental challenge in treatment effect estimation. Even when researchers credibly identify average treatment effects – for example through randomized experiments – the results may not extrapolate to the population of interest for a given policy question. If the population and sample differ only in the distribution of observed variables this problem has a well-known solution: reweight the sample to match the population. In many cases, however, the population and sample differ along dimensions unobserved by the researcher. We provide a tractable framework for thinking about external validity in such cases. Our approach relies on the fact that when the sample is drawn from the same support as the population of interest there exist weights which, if known, would allow us to reweight the sample to match the population. These weights are larger in a stochastic sense when the sample is more selected, and their correlation with a given variable reflects the intensity of selection along this dimension. We suggest natural benchmarks for assessing external validity, discuss implementation, and apply our results to data from several recent experiments.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86680579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We study the welfare implications of scalable price targeting, an extreme form of third-degree price discrimination implemented with machine learning for a large, digital firm. Targeted prices are computed by solving the firm's Bayesian Decision-Theoretic pricing problem based on a database with a high-dimensional vector of customer features that are observed prior to the price quote. To identify the causal effect of price on demand, we first run a large, randomized price experiment and use these data to train our demand model. We use l1 regularization (lasso) to select the set of customer features that moderate the heterogeneous treatment effect of price on demand. We use a weighted likelihood Bayesian bootstrap to quantify the firm's approximate statistical uncertainty in demand and profitability. We then conduct a second experiment that implements our proposed price targeting scheme out of sample. Theoretically, both firm and customer surplus could rise with scalable price targeting. Optimized uniform pricing improves revenues by 64.9% relative to the control pricing, whereas scalable price targeting improves revenues by 81.5%. Firm profits increase by over 10% under targeted pricing relative to optimal uniform pricing. Customer surplus declines by less than 1% with price targeting; although nearly 70% of customers are charged less than the uniform price. Our weighted likelihood bootstrap estimator also predicts demand and demand uncertainty out of sample better than several alternative approaches.
{"title":"Scalable Price Targeting","authors":"Jean-Pierre Dubé, S. Misra","doi":"10.3386/W23775","DOIUrl":"https://doi.org/10.3386/W23775","url":null,"abstract":"We study the welfare implications of scalable price targeting, an extreme form of third-degree price discrimination implemented with machine learning for a large, digital firm. Targeted prices are computed by solving the firm's Bayesian Decision-Theoretic pricing problem based on a database with a high-dimensional vector of customer features that are observed prior to the price quote. To identify the causal effect of price on demand, we first run a large, randomized price experiment and use these data to train our demand model. We use l1 regularization (lasso) to select the set of customer features that moderate the heterogeneous treatment effect of price on demand. We use a weighted likelihood Bayesian bootstrap to quantify the firm's approximate statistical uncertainty in demand and profitability. We then conduct a second experiment that implements our proposed price targeting scheme out of sample. Theoretically, both firm and customer surplus could rise with scalable price targeting. Optimized uniform pricing improves revenues by 64.9% relative to the control pricing, whereas scalable price targeting improves revenues by 81.5%. Firm profits increase by over 10% under targeted pricing relative to optimal uniform pricing. Customer surplus declines by less than 1% with price targeting; although nearly 70% of customers are charged less than the uniform price. Our weighted likelihood bootstrap estimator also predicts demand and demand uncertainty out of sample better than several alternative approaches.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79738029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Hansen, Benjamin Hansen, Benjamin Hansen, Keaton S. Miller, Caroline Weber
Marijuana is partially prohibited: though banned federally, it is available to 1 in 4 U.S. adults under state statutes. We measure the size of the interstate trade generated by state-level differences in legal status with a natural experiment: Oregon allowed stores to sell marijuana for recreational use on October 1, 2015, next to Washington where stores had been selling recreational marijuana since July 2014. Using administrative data covering the universe of Washington's sales and a differences-in-discontinuities approach, we find retailers along the Oregon border experienced a 36 percent decline in sales immediately after Oregon's market opened. We investigate the home location of recent online reviewers of marijuana retailers and find similar cross-border patterns. By the end of Washington's 2018 fiscal year, our results imply that Washington had earned between $44 million and $75 million in tax revenue from cross-border shoppers. These cross-border incentives may create a “race to legalize.”
{"title":"Federalism, Partial Prohibition, and Cross-Border Sales: Evidence from Recreational Marijuana","authors":"Benjamin Hansen, Benjamin Hansen, Benjamin Hansen, Keaton S. Miller, Caroline Weber","doi":"10.3386/W23762","DOIUrl":"https://doi.org/10.3386/W23762","url":null,"abstract":"Marijuana is partially prohibited: though banned federally, it is available to 1 in 4 U.S. adults under state statutes. We measure the size of the interstate trade generated by state-level differences in legal status with a natural experiment: Oregon allowed stores to sell marijuana for recreational use on October 1, 2015, next to Washington where stores had been selling recreational marijuana since July 2014. Using administrative data covering the universe of Washington's sales and a differences-in-discontinuities approach, we find retailers along the Oregon border experienced a 36 percent decline in sales immediately after Oregon's market opened. We investigate the home location of recent online reviewers of marijuana retailers and find similar cross-border patterns. By the end of Washington's 2018 fiscal year, our results imply that Washington had earned between $44 million and $75 million in tax revenue from cross-border shoppers. These cross-border incentives may create a “race to legalize.”","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78831629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The median United States voter supports the legalization of marijuana, at least in part due to a desire to increase state tax revenues. However, states with legal markets have implemented wildly different regulatory schemes with tax rates ranging from 3.75 to 37 percent, indicating that policy makers have a range of beliefs about industry responses to taxes and regulation. We examine a policy reform in Washington: a switch from a 25 percent gross receipts tax collected at every step in the supply chain to a sole 37 percent excise tax at retail. Using novel, comprehensive administrative data, we assess responses to the reform throughout the supply and consumption chain. We find the previous tax regime provided strong incentives for vertical integration. Tax invariance did not hold, with some types of firms benefiting much more than predicted. Consumers bear 44 percent of the additional retail tax burden. Finally, we find evidence that consumer demand for marijuana is price-inelastic in the short-run, but becomes price-elastic within a few weeks of a price increase.
{"title":"The Taxation of Recreational Marijuana: Evidence from Washington State","authors":"Benjamin C. Hansen, Keaton S. Miller, C. Weber","doi":"10.3386/W23632","DOIUrl":"https://doi.org/10.3386/W23632","url":null,"abstract":"The median United States voter supports the legalization of marijuana, at least in part due to a desire to increase state tax revenues. However, states with legal markets have implemented wildly different regulatory schemes with tax rates ranging from 3.75 to 37 percent, indicating that policy makers have a range of beliefs about industry responses to taxes and regulation. We examine a policy reform in Washington: a switch from a 25 percent gross receipts tax collected at every step in the supply chain to a sole 37 percent excise tax at retail. Using novel, comprehensive administrative data, we assess responses to the reform throughout the supply and consumption chain. We find the previous tax regime provided strong incentives for vertical integration. Tax invariance did not hold, with some types of firms benefiting much more than predicted. Consumers bear 44 percent of the additional retail tax burden. Finally, we find evidence that consumer demand for marijuana is price-inelastic in the short-run, but becomes price-elastic within a few weeks of a price increase.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79260796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper contributes to the debate on the impact of juvenile punishment on adult criminal recidivism and high school completion. We link the universe of case files of those who were convicted of a crime as a juvenile between 1996 and 2012 in a southern U.S. state to the public school administrative records and to adult criminal records. The detail of the data allows us to utilize information on the exact types of crimes committed, as well as the type and duration of punishment imposed, both as a juvenile and as an adult. We exploit random assignment of cases to judges and use idiosyncratic judge stringency in imprisonment to estimate the causal effect of incarceration on adult crime and on high school completion. Incarceration has a detrimental impact on high school completion for earlier cohorts, but it has no impact on later cohorts, arguably because of the school reform implemented in the state in the late 1990s. We find that incarceration as a juvenile has no impact on future violent crime, but it lowers the propensity to commit property crime. Juvenile incarceration increases the propensity of being convicted for a drug offense in adulthood, but this effect is largely driven by time spent in prison as a juvenile. Specifically, juvenile incarceration has no statistically significant impact on adult drug offenses if time spent in prison is less than the median, but longer incarceration increases adult drug conviction, arguably because longer prison stays intensify emotional stress, leading to drug use.
{"title":"Juvenile Punishment, High School Graduation and Adult Crime: Evidence from Idiosyncratic Judge Harshness","authors":"Ozkan Eren, N. Mocan, N. Mocan","doi":"10.3386/W23573","DOIUrl":"https://doi.org/10.3386/W23573","url":null,"abstract":"This paper contributes to the debate on the impact of juvenile punishment on adult criminal recidivism and high school completion. We link the universe of case files of those who were convicted of a crime as a juvenile between 1996 and 2012 in a southern U.S. state to the public school administrative records and to adult criminal records. The detail of the data allows us to utilize information on the exact types of crimes committed, as well as the type and duration of punishment imposed, both as a juvenile and as an adult. We exploit random assignment of cases to judges and use idiosyncratic judge stringency in imprisonment to estimate the causal effect of incarceration on adult crime and on high school completion. Incarceration has a detrimental impact on high school completion for earlier cohorts, but it has no impact on later cohorts, arguably because of the school reform implemented in the state in the late 1990s. We find that incarceration as a juvenile has no impact on future violent crime, but it lowers the propensity to commit property crime. Juvenile incarceration increases the propensity of being convicted for a drug offense in adulthood, but this effect is largely driven by time spent in prison as a juvenile. Specifically, juvenile incarceration has no statistically significant impact on adult drug offenses if time spent in prison is less than the median, but longer incarceration increases adult drug conviction, arguably because longer prison stays intensify emotional stress, leading to drug use.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74932824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leonardo Bursztyn, Davide Cantoni, Patricia Funk, Felix Schönenberger, Noam Yuchtman
We provide evidence of a causal effect of anticipated election closeness on voter turnout, exploiting the precise day-level timing of the release of Swiss national poll results for high-stakes federal referenda, and a novel dataset on daily mail-in voting for the canton of Geneva. Using an event study design, we find that the release of a closer poll causes voter turnout to sharply rise immediately after poll release, with no differential pre-release turnout levels or trends. We provide evidence that polls affect turnout by providing information shaping beliefs about closeness: first, the introduction of Swiss polls had significantly larger effects in politically unrepresentative municipalities, where locally available signals of closeness are less correlated with national closeness. Second, the effects of close polls are largest where newspapers report on them most. Counterfactual exercises suggest the importance of polls and reporting on polls in shaping election outcomes.
{"title":"Identifying the Effect of Election Closeness on Voter Turnout: Evidence from Swiss Referenda","authors":"Leonardo Bursztyn, Davide Cantoni, Patricia Funk, Felix Schönenberger, Noam Yuchtman","doi":"10.3386/w23490","DOIUrl":"https://doi.org/10.3386/w23490","url":null,"abstract":"We provide evidence of a causal effect of anticipated election closeness on voter turnout, exploiting the precise day-level timing of the release of Swiss national poll results for high-stakes federal referenda, and a novel dataset on daily mail-in voting for the canton of Geneva. Using an event study design, we find that the release of a closer poll causes voter turnout to sharply rise immediately after poll release, with no differential pre-release turnout levels or trends. We provide evidence that polls affect turnout by providing information shaping beliefs about closeness: first, the introduction of Swiss polls had significantly larger effects in politically unrepresentative municipalities, where locally available signals of closeness are less correlated with national closeness. Second, the effects of close polls are largest where newspapers report on them most. Counterfactual exercises suggest the importance of polls and reporting on polls in shaping election outcomes.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76468527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beliefs about whether effort pays off govern some of the most fundamental choices individuals make. This paper uses China’s Cultural Revolution to understand how these beliefs can be affected, how they impact behavior, and how they are transmitted across generations. During the Cultural Revolution, China’s college admission system based on entrance exams was suspended for a decade until 1976, effectively depriving an entire generation of young people of the opportunity to access higher education (the “lost generation”). Using data from a nationally representative survey, we compare cohorts who graduated from high school just before and after the college entrance exam was resumed. We find that members of the “lost generation” who missed out on college because they were born just a year or two too early believe that effort pays off to a much lesser degree, even 40 years into their adulthood. However, they invested more in their children’s education, and transmitted less of their changed beliefs to the next generation, suggesting attempts to safeguard their children from sharing their misfortunes.
{"title":"China's Lost Generation: Changes in Beliefs and Their Intergenerational Transmission","authors":"G. Roland, David Y. Yang","doi":"10.3386/W23441","DOIUrl":"https://doi.org/10.3386/W23441","url":null,"abstract":"Beliefs about whether effort pays off govern some of the most fundamental choices individuals make. This paper uses China’s Cultural Revolution to understand how these beliefs can be affected, how they impact behavior, and how they are transmitted across generations. During the Cultural Revolution, China’s college admission system based on entrance exams was suspended for a decade until 1976, effectively depriving an entire generation of young people of the opportunity to access higher education (the “lost generation”). Using data from a nationally representative survey, we compare cohorts who graduated from high school just before and after the college entrance exam was resumed. We find that members of the “lost generation” who missed out on college because they were born just a year or two too early believe that effort pays off to a much lesser degree, even 40 years into their adulthood. However, they invested more in their children’s education, and transmitted less of their changed beliefs to the next generation, suggesting attempts to safeguard their children from sharing their misfortunes.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90579109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toshiaki Iizuka, Katsuhiko Nishiyama, Brian K Chen, K. Eggleston
Using unique individual-level panel data, we investigate whether preventive medical care triggered by health checkups is worth the cost. We exploit the fact that biomarkers just below and above a threshold may be viewed as random. We find that people respond to health signals and increase physician visits. However, we find no evidence that additional care is cost effective. For the “borderline type” (“pre-diabetes”) threshold for diabetes, medical care utilization increases but neither physical measures nor predicted risks of mortality or serious complications improve. For efficient use of medical resources, cost effectiveness of preventive care must be carefully examined.
{"title":"Is Preventive Care Worth the Cost? Evidence from Mandatory Checkups in Japan","authors":"Toshiaki Iizuka, Katsuhiko Nishiyama, Brian K Chen, K. Eggleston","doi":"10.3386/W23413","DOIUrl":"https://doi.org/10.3386/W23413","url":null,"abstract":"Using unique individual-level panel data, we investigate whether preventive medical care triggered by health checkups is worth the cost. We exploit the fact that biomarkers just below and above a threshold may be viewed as random. We find that people respond to health signals and increase physician visits. However, we find no evidence that additional care is cost effective. For the “borderline type” (“pre-diabetes”) threshold for diabetes, medical care utilization increases but neither physical measures nor predicted risks of mortality or serious complications improve. For efficient use of medical resources, cost effectiveness of preventive care must be carefully examined.","PeriodicalId":18934,"journal":{"name":"National Bureau of Economic Research","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78645734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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