Pub Date : 2021-10-07DOI: 10.24187/ecostat.2021.526d.2051
C. Carbonnier
{"title":"Family-Based Tax and Transfer System – Issues for Income Tax and Other Public Policies","authors":"C. Carbonnier","doi":"10.24187/ecostat.2021.526d.2051","DOIUrl":"https://doi.org/10.24187/ecostat.2021.526d.2051","url":null,"abstract":"","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125703236","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}
Pub Date : 2021-10-07DOI: 10.24187/ecostat.2021.526d.2053
Laila AitBihiOuali, O. Bargain
{"title":"Undeclared Work – Evidence from France","authors":"Laila AitBihiOuali, O. Bargain","doi":"10.24187/ecostat.2021.526d.2053","DOIUrl":"https://doi.org/10.24187/ecostat.2021.526d.2053","url":null,"abstract":"","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121982147","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}
Pub Date : 2021-10-07DOI: 10.24187/ecostat.2021.526d.2052
F. Bonnet, Hippolyte d’Albis, Âurélie Sotura
{"title":"Income Inequality across French Departments over the Last 100 Years","authors":"F. Bonnet, Hippolyte d’Albis, Âurélie Sotura","doi":"10.24187/ecostat.2021.526d.2052","DOIUrl":"https://doi.org/10.24187/ecostat.2021.526d.2052","url":null,"abstract":"","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"189 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131584071","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}
Pub Date : 2021-07-21DOI: 10.24187/ECOSTAT.2021.524D.2045
B. Dormont, Aimée Kingsada, A. Samson
[eng] In 2009, a system of pay-for-performance (P4P) was offered to physicians in France via the Contrat d’Amelioration des Pratiques Individuelles (CAPI). This study assesses the causal impact of CAPI on their behaviour in terms of care provision. Based on a panel of general practitioners in private practice observed before (2005 and 2008) and after (2011) its introduction, we use an instrumental variables approach, applied to a model in first-differences in order to correct the endogeneity biases linked to the fact that signing up to CAPI is a choice. We show that, unlike other practitioners, those who have signed up to CAPI have not reduced their number of consultations per patient or the amount of prescriptions per patient. They have also increased, to a greater extent than others, the proportion of their patients who they treat as the primary care doctor(i.e. the medecin traitant). Moreover, CAPI has enabled them to increase their fees per patient with, as a consequence, a higher treatment cost for the Social Security system.
{"title":"The Introduction of Pay-for-Performance: What Impact on General Practitioners' Activity in France?","authors":"B. Dormont, Aimée Kingsada, A. Samson","doi":"10.24187/ECOSTAT.2021.524D.2045","DOIUrl":"https://doi.org/10.24187/ECOSTAT.2021.524D.2045","url":null,"abstract":"[eng] In 2009, a system of pay-for-performance (P4P) was offered to physicians in France via the Contrat d’Amelioration des Pratiques Individuelles (CAPI). This study assesses the causal impact of CAPI on their behaviour in terms of care provision. Based on a panel of general practitioners in private practice observed before (2005 and 2008) and after (2011) its introduction, we use an instrumental variables approach, applied to a model in first-differences in order to correct the endogeneity biases linked to the fact that signing up to CAPI is a choice. We show that, unlike other practitioners, those who have signed up to CAPI have not reduced their number of consultations per patient or the amount of prescriptions per patient. They have also increased, to a greater extent than others, the proportion of their patients who they treat as the primary care doctor(i.e. the medecin traitant). Moreover, CAPI has enabled them to increase their fees per patient with, as a consequence, a higher treatment cost for the Social Security system.","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129527046","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}
Pub Date : 2021-07-21DOI: 10.24187/ecostat.2021.524d.2041
C. Franc
[eng] Over the past decade, the journal Economie et Statistique has devoted two special issues to health economics. After the special issues published in 2013 and 2016, this Thematic Section brings together a selection of articles from the 41st Journees des economistes de la sante francais (JESF, Annual congress of French health economists) held at the University of Poitiers in December 2019.
{"title":"Introduction to the Thematic Section on Health Economics","authors":"C. Franc","doi":"10.24187/ecostat.2021.524d.2041","DOIUrl":"https://doi.org/10.24187/ecostat.2021.524d.2041","url":null,"abstract":"[eng] Over the past decade, the journal Economie et Statistique has devoted two special issues to health economics. After the special issues published in 2013 and 2016, this Thematic Section brings together a selection of articles from the 41st Journees des economistes de la sante francais (JESF, Annual congress of French health economists) held at the University of Poitiers in December 2019.","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124413296","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}
Pub Date : 2021-07-21DOI: 10.24187/ECOSTAT.2021.524D.2044
C. Peyron, A. Pélissier, N. Krucien
[eng] This study analyses the preferences of the French population with regard to the genetic information that is potentially accessible thanks to genomic medicine. More specifically, it is a question of knowing whether or not the French population (i) is in favour of knowing all possible results with regard to genetic predispositions; (ii) has preferences with regard to the person or the method that would decide upon the list of accessible results; (iii) is in favour of researchers having access to patients’ genetic data. This study makes use of the discrete choice method, with an online survey, conducted in France with a representative sample of 2,501 respondents. The choice data were analyzed in a mixed logit model, to explore the variability of preferences. The results show a preference for autonomy in choosing the information communicated, to access the most comprehensive genetic results possible and for a contribution to research through the provision of genetic data.
{"title":"Preferences of the French Population Regarding Access to Genetic Information: A Discrete Choice Experiment","authors":"C. Peyron, A. Pélissier, N. Krucien","doi":"10.24187/ECOSTAT.2021.524D.2044","DOIUrl":"https://doi.org/10.24187/ECOSTAT.2021.524D.2044","url":null,"abstract":"[eng] This study analyses the preferences of the French population with regard to the genetic information that is potentially accessible thanks to genomic medicine. More specifically, it is a question of knowing whether or not the French population (i) is in favour of knowing all possible results with regard to genetic predispositions; (ii) has preferences with regard to the person or the method that would decide upon the list of accessible results; (iii) is in favour of researchers having access to patients’ genetic data. This study makes use of the discrete choice method, with an online survey, conducted in France with a representative sample of 2,501 respondents. The choice data were analyzed in a mixed logit model, to explore the variability of preferences. The results show a preference for autonomy in choosing the information communicated, to access the most comprehensive genetic results possible and for a contribution to research through the provision of genetic data.","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116728217","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}
Pub Date : 2021-07-21DOI: 10.24187/ECOSTAT.2021.524D.2047
Agathe Dardier
[eng] Combining work and a pension is one of the ways of extending ones working life that is being encouraged under the 2003 pension reforms. In 2019, 3% of retirees under the general scheme were thus in paid employment in the private sector and, of individuals having retired under the general scheme since 1 January 2004, 10% were in paid employment in the private sector between 2005 and 2016. This article seeks to identify the key characteristics of these employed retirees, or “combiners”, prior to any changes in the legislation. The analysis, carried out using administrative data gathered by the CNAV (the French national old-age insurance), shows that the two factors which contribute most to a decision to return to work after retirement are having been in employment before retiring and having the length of insurance cover required for a full pension. Three typical combiner profiles are identified: a profile of men who have had long careers and taken early retirement (24%), a profile of executives (45%) and a profile of women with spells out of work (31%).
{"title":"Combining Work and a Pension – Individual Determining Factors and Combiners’ Profiles","authors":"Agathe Dardier","doi":"10.24187/ECOSTAT.2021.524D.2047","DOIUrl":"https://doi.org/10.24187/ECOSTAT.2021.524D.2047","url":null,"abstract":"[eng] Combining work and a pension is one of the ways of extending ones working life that is being encouraged under the 2003 pension reforms. In 2019, 3% of retirees under the general scheme were thus in paid employment in the private sector and, of individuals having retired under the general scheme since 1 January 2004, 10% were in paid employment in the private sector between 2005 and 2016. This article seeks to identify the key characteristics of these employed retirees, or “combiners”, prior to any changes in the legislation. The analysis, carried out using administrative data gathered by the CNAV (the French national old-age insurance), shows that the two factors which contribute most to a decision to return to work after retirement are having been in employment before retiring and having the length of insurance cover required for a full pension. Three typical combiner profiles are identified: a profile of men who have had long careers and taken early retirement (24%), a profile of executives (45%) and a profile of women with spells out of work (31%).","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134236391","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}
Pub Date : 2021-07-21DOI: 10.24187/ECOSTAT.2021.524D.2042
Louis Arnault, J. Wittwer
[eng] The law on the adaptation of society to ageing, which reformed the home care allowance APA, entered into force on 1 March 2016. This article aims to study the effect of this on the amounts proposed in plans by the medical and welfare teams (EMS), first theoretically and then empirically, on more than 300,000 beneficiaries in 2011 and 2017. The analysis is based on individual data from the statistical services of the Ministry of Health and Social Affairs (DREES). The average amount offered to beneficiaries assessed as belonging to the iso-resource group of dependence (GIR) 3, 2 or 1 saw a respective increase of €16, €49 and €57 between 2011 and 2017. The amount offered to most beneficiaries allocated to GIR 4 decreased, other things being equal. Within each GIR, in 2017, the amounts granted are more widely distributed, in both directions, which suggests that constraints on departements’ council budgets have led EMS to cut allowances for people with relatively more autonomy so as to provide more funding for the most severely dependent people.
{"title":"The Effect of the 2015 Reform of the Personalized Autonomy Allowance on the Care Plans Notified to Beneficiaries","authors":"Louis Arnault, J. Wittwer","doi":"10.24187/ECOSTAT.2021.524D.2042","DOIUrl":"https://doi.org/10.24187/ECOSTAT.2021.524D.2042","url":null,"abstract":"[eng] The law on the adaptation of society to ageing, which reformed the home care allowance APA, entered into force on 1 March 2016. This article aims to study the effect of this on the amounts proposed in plans by the medical and welfare teams (EMS), first theoretically and then empirically, on more than 300,000 beneficiaries in 2011 and 2017. The analysis is based on individual data from the statistical services of the Ministry of Health and Social Affairs (DREES). The average amount offered to beneficiaries assessed as belonging to the iso-resource group of dependence (GIR) 3, 2 or 1 saw a respective increase of €16, €49 and €57 between 2011 and 2017. The amount offered to most beneficiaries allocated to GIR 4 decreased, other things being equal. Within each GIR, in 2017, the amounts granted are more widely distributed, in both directions, which suggests that constraints on departements’ council budgets have led EMS to cut allowances for people with relatively more autonomy so as to provide more funding for the most severely dependent people.","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117279631","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}
Pub Date : 2021-07-21DOI: 10.24187/ECOSTAT.2021.524D.2046
B. Dormont, Cécile Gayet
[eng] Whilst it is forbidden to charge patients with CMU-C health cover fees in excess of the reimbursable regulated fee (or extra fees), so as to make their access to care easier, field experiment studies report discrimination against the latter by physicians. This issue is approached here from the angle of healthcare supply, using four waves of longitudinal administrative data on physicians in private practice between 2005 and 2014. We examine whether this ban on excess fees for CMU-C beneficiaries, i.e. charging them fees in excess of the standard social security-negotiated fees agreed under the public health insurance scheme, generates a real financial constraint for Sector 2 physicians (those who charge extra-fees) and dentists in private practice. Estimates show a significant drop in the average extra-fees per procedure when physicians accept more CMU-C patients in their practice. Even if costs are transferred (cost-shifting), with other patients being charged higher extra-fees, this is not enough to offset the financial impact. However, this restriction does not have a negative impact on total fees for Sector 2 specialists, general practitioners and dentists, as they increase their volume of activity at the same time.
{"title":"The Ban on Extra-Fees for Beneficiaries of the CMU-C Health Cover: What Consequences for Physicians and Dentists in Private Practice?","authors":"B. Dormont, Cécile Gayet","doi":"10.24187/ECOSTAT.2021.524D.2046","DOIUrl":"https://doi.org/10.24187/ECOSTAT.2021.524D.2046","url":null,"abstract":"[eng] Whilst it is forbidden to charge patients with CMU-C health cover fees in excess of the reimbursable regulated fee (or extra fees), so as to make their access to care easier, field experiment studies report discrimination against the latter by physicians. This issue is approached here from the angle of healthcare supply, using four waves of longitudinal administrative data on physicians in private practice between 2005 and 2014. We examine whether this ban on excess fees for CMU-C beneficiaries, i.e. charging them fees in excess of the standard social security-negotiated fees agreed under the public health insurance scheme, generates a real financial constraint for Sector 2 physicians (those who charge extra-fees) and dentists in private practice. Estimates show a significant drop in the average extra-fees per procedure when physicians accept more CMU-C patients in their practice. Even if costs are transferred (cost-shifting), with other patients being charged higher extra-fees, this is not enough to offset the financial impact. However, this restriction does not have a negative impact on total fees for Sector 2 specialists, general practitioners and dentists, as they increase their volume of activity at the same time.","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"204 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122595497","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}
Pub Date : 2021-07-21DOI: 10.24187/ECOSTAT.2021.524D.2043
Estelle Augé, N. Sirven
[eng] This study analyses the healthcare consumption of self-employed workers (SEW) versus employees, at different ages in France. It is based on 2012 cross-sectional data from the French Health, Healthcare and Insurance Survey (ESPS) matched with National Health Insurance data. We decompose healthcare demand (ambulatory and inpatient care) at different ages and by gender using a two-step model. The results show that, ceteris paribus, SEW (especially men) tend to consume less ambulatory care in the early stages of their working life, as their job is more demanding (‘must-trade’ effect), while their consumption gradually increases with age, reaching the levels of other categories of workers after retirement (‘catch-up’ effect). These results, in line with economic theory, suggest that SEW’s health declines faster over the life cycle. From a public policy perspective, they challenge, on the grounds of public health, the EU2020 strategy advocating the development of SEW in Europe.
{"title":"‘Must-Trade and Catch-Up’ – Do the Self-Employed Under-Invest in Their Health?","authors":"Estelle Augé, N. Sirven","doi":"10.24187/ECOSTAT.2021.524D.2043","DOIUrl":"https://doi.org/10.24187/ECOSTAT.2021.524D.2043","url":null,"abstract":"[eng] This study analyses the healthcare consumption of self-employed workers (SEW) versus employees, at different ages in France. It is based on 2012 cross-sectional data from the French Health, Healthcare and Insurance Survey (ESPS) matched with National Health Insurance data. We decompose healthcare demand (ambulatory and inpatient care) at different ages and by gender using a two-step model. The results show that, ceteris paribus, SEW (especially men) tend to consume less ambulatory care in the early stages of their working life, as their job is more demanding (‘must-trade’ effect), while their consumption gradually increases with age, reaching the levels of other categories of workers after retirement (‘catch-up’ effect). These results, in line with economic theory, suggest that SEW’s health declines faster over the life cycle. From a public policy perspective, they challenge, on the grounds of public health, the EU2020 strategy advocating the development of SEW in Europe.","PeriodicalId":431625,"journal":{"name":"Economie et Statistique / Economics and Statistics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116031468","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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