Pharmaceutical companies market to physicians through individual detailing accompanied by monetary or in-kind transfers. Large compensation payments to a small number of physicians account for most of this promotional spending. Studying US promotional payments and prescriptions for anticoagulant drugs, we investigate how peer influence broadens the payments' reach. Following a compensation payment, prescriptions for the marketed drug increase by both the paid physician and the paid physician's peers. Payments increase prescriptions to both recommended and contraindicated patients. Over three years, marketed anticoagulant prescriptions rose 23 percent due to payments, with peer spillovers contributing a quarter of the increase.
{"title":"Drug Diffusion Through Peer Networks: The Influence of Industry Payments.","authors":"Leila Agha, Dan Zeltzer","doi":"10.1257/pol.20200044","DOIUrl":"https://doi.org/10.1257/pol.20200044","url":null,"abstract":"<p><p>Pharmaceutical companies market to physicians through individual detailing accompanied by monetary or in-kind transfers. Large compensation payments to a small number of physicians account for most of this promotional spending. Studying US promotional payments and prescriptions for anticoagulant drugs, we investigate how peer influence broadens the payments' reach. Following a compensation payment, prescriptions for the marketed drug increase by both the paid physician and the paid physician's peers. Payments increase prescriptions to both recommended and contraindicated patients. Over three years, marketed anticoagulant prescriptions rose 23 percent due to payments, with peer spillovers contributing a quarter of the increase.</p>","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"14 2","pages":"1-33"},"PeriodicalIF":5.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387671/pdf/nihms-1764085.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40714676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many scholars have studied the employment effects of minimum wages, but little is known about effects on the composition of hires. I investigate whether Germany’s minimum wage introduction raised hiring standards, using worker fixed effects as a proxy for worker productivity. For the least productive workers hired, the minimum wage led to a 4 percentile point shift in the productivity distribution. This increase is missed using standard observable measures of worker productivity. The effects are larger with greater pre-reform screening intensity—indicating an employer response. This more selective hiring compensates about two-thirds of higher wage costs for the least productive hires. (JEL J23, J24, J31, J38, M51)
{"title":"Raising the Bar: Minimum Wages and Employers’ Hiring Standards","authors":"Sebastian Butschek","doi":"10.1257/pol.20190534","DOIUrl":"https://doi.org/10.1257/pol.20190534","url":null,"abstract":"Many scholars have studied the employment effects of minimum wages, but little is known about effects on the composition of hires. I investigate whether Germany’s minimum wage introduction raised hiring standards, using worker fixed effects as a proxy for worker productivity. For the least productive workers hired, the minimum wage led to a 4 percentile point shift in the productivity distribution. This increase is missed using standard observable measures of worker productivity. The effects are larger with greater pre-reform screening intensity—indicating an employer response. This more selective hiring compensates about two-thirds of higher wage costs for the least productive hires. (JEL J23, J24, J31, J38, M51)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"51 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83045312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper provides evidence that replacing minimum unemployment benefits with a basic income of equal size has minor employment effects at best. We examine an experiment in Finland in which 2,000 benefit recipients were randomized to receive a monthly basic income. The experiment lowered participation tax rates by 23 percentage points for full-time employment. Despite the considerable increase in work incentives, days in employment remained statistically unchanged in the first year of the experiment. Moreover, even though all job search requirements were waived, participation in reemployment services remained high. (JEL C93, H24, H53, I38, J64, J65)
{"title":"Removing Welfare Traps: Employment Responses in the Finnish Basic Income Experiment","authors":"Jouko Verho, Kari Hämäläinen, Ohto Kanninen","doi":"10.1257/pol.20200143","DOIUrl":"https://doi.org/10.1257/pol.20200143","url":null,"abstract":"This paper provides evidence that replacing minimum unemployment benefits with a basic income of equal size has minor employment effects at best. We examine an experiment in Finland in which 2,000 benefit recipients were randomized to receive a monthly basic income. The experiment lowered participation tax rates by 23 percentage points for full-time employment. Despite the considerable increase in work incentives, days in employment remained statistically unchanged in the first year of the experiment. Moreover, even though all job search requirements were waived, participation in reemployment services remained high. (JEL C93, H24, H53, I38, J64, J65)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"47 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines the impacts of two distinct types of school spending on student outcomes. State-imposed revenue limits cap the total amount of revenue that a school district in Wisconsin can raise unless the district holds a referendum asking voters to exceed the cap. Importantly, Wisconsin law requires districts to hold separate referenda for operational and capital expenditures, which allows for estimating their independent effects. Leveraging close elections in a dynamic regression discontinuity framework, I find that increases in operational spending have substantial positive effects on test scores, dropout rates, and postsecondary enrollment, but additional capital expenditures have little impact. (JEL D72, H75, I21, I22, I28)
{"title":"School Spending and Student Outcomes: Evidence from Revenue Limit Elections in Wisconsin","authors":"E. Jason Baron","doi":"10.1257/pol.20200226","DOIUrl":"https://doi.org/10.1257/pol.20200226","url":null,"abstract":"This study examines the impacts of two distinct types of school spending on student outcomes. State-imposed revenue limits cap the total amount of revenue that a school district in Wisconsin can raise unless the district holds a referendum asking voters to exceed the cap. Importantly, Wisconsin law requires districts to hold separate referenda for operational and capital expenditures, which allows for estimating their independent effects. Leveraging close elections in a dynamic regression discontinuity framework, I find that increases in operational spending have substantial positive effects on test scores, dropout rates, and postsecondary enrollment, but additional capital expenditures have little impact. (JEL D72, H75, I21, I22, I28)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"21 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent decades, gentrification has transformed American central city neighborhoods. I estimate a spatial equilibrium model to show that the rising value of high-skilled workers’ time contributes to the gentrification of American central cities. I show that the increasing value of time raises the cost of commuting and exogenously increases the demand for central locations by high-skilled workers. While change in the value of time has a modest direct effect on gentrification of central cities, the effect is substantially magnified by endogenous amenity change driven by the changes in local skill mix. (JEL J22, J24, R21, R23)
{"title":"The Rising Value of Time and the Origin of Urban Gentrification","authors":"Yichen Su","doi":"10.1257/pol.20190550","DOIUrl":"https://doi.org/10.1257/pol.20190550","url":null,"abstract":"In recent decades, gentrification has transformed American central city neighborhoods. I estimate a spatial equilibrium model to show that the rising value of high-skilled workers’ time contributes to the gentrification of American central cities. I show that the increasing value of time raises the cost of commuting and exogenously increases the demand for central locations by high-skilled workers. While change in the value of time has a modest direct effect on gentrification of central cities, the effect is substantially magnified by endogenous amenity change driven by the changes in local skill mix. (JEL J22, J24, R21, R23)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"29 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Acid Rain Program (ARP) cut sulfur dioxide (SO2) emissions from power plants in the United States, with considerable benefits. We show this also reduced ambient sulfate levels, which lowered agriculture productivity through decreased soil sulfur. Using plant-level SO2 emissions and an atmospheric transport model, we estimate the relationship between airborne sulfate levels and yields for corn and soybeans. We estimate crop revenue losses for these two crops at around $1–$1.5 billion per year, with accompanying decreases in land value. Back-of-the-envelope calculations of the costs to replace lost sulfur suggest producer responses were limited and suboptimal. (JEL Q15, Q24, Q53, Q58)
{"title":"Adaptation to Environmental Change: Agriculture and the Unexpected Incidence of the Acid Rain Program","authors":"Nicholas J. Sanders, Alan I. Barreca","doi":"10.1257/pol.20190060","DOIUrl":"https://doi.org/10.1257/pol.20190060","url":null,"abstract":"The Acid Rain Program (ARP) cut sulfur dioxide (SO<jats:sub>2</jats:sub>) emissions from power plants in the United States, with considerable benefits. We show this also reduced ambient sulfate levels, which lowered agriculture productivity through decreased soil sulfur. Using plant-level SO<jats:sub>2</jats:sub> emissions and an atmospheric transport model, we estimate the relationship between airborne sulfate levels and yields for corn and soybeans. We estimate crop revenue losses for these two crops at around $1–$1.5 billion per year, with accompanying decreases in land value. Back-of-the-envelope calculations of the costs to replace lost sulfur suggest producer responses were limited and suboptimal. (JEL Q15, Q24, Q53, Q58)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"1 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper uses changes in mortgage lenders’ minimum credit score thresholds to credibly identify the effects of access to household credit. Falling under these thresholds has very large negative effects on borrowing for up to two years, and these effects fail to reverse within four years. The effects are particularly concentrated among individuals who have relatively high credit demand and face relatively large contractions in credit supply. In addition, access to new mortgage credit reduces delinquency on nonmortgage debt and appears to spill over to demand for auto loans. (JEL G21, G51, R21)
{"title":"The Effects of Mortgage Credit Availability: Evidence from Minimum Credit Score Lending Rules","authors":"Steven Laufer, Andrew Paciorek","doi":"10.1257/pol.20180229","DOIUrl":"https://doi.org/10.1257/pol.20180229","url":null,"abstract":"This paper uses changes in mortgage lenders’ minimum credit score thresholds to credibly identify the effects of access to household credit. Falling under these thresholds has very large negative effects on borrowing for up to two years, and these effects fail to reverse within four years. The effects are particularly concentrated among individuals who have relatively high credit demand and face relatively large contractions in credit supply. In addition, access to new mortgage credit reduces delinquency on nonmortgage debt and appears to spill over to demand for auto loans. (JEL G21, G51, R21)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"29 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
College admissions in the United States are decentralized, creating frictions that limit student choice. We study the Common Application (CA) platform, under which students submit a single application to member schools, potentially reducing frictions and increasing student choice. The CA increases the number of applications received by schools, reflecting a reduction in frictions, and reduces the yield on accepted students, reflecting increased choice. The CA increases out-of-state enrollment, especially from other CA states, consistent with network effects. Entry into the CA changes the composition of students, with evidence of more racial diversity and more high-income students and imprecise evidence of increases in SAT scores. (JEL I23, I28)
{"title":"Reducing Frictions in College Admissions: Evidence from the Common Application","authors":"Brian Knight, Nathan Schiff","doi":"10.1257/pol.20190694","DOIUrl":"https://doi.org/10.1257/pol.20190694","url":null,"abstract":"College admissions in the United States are decentralized, creating frictions that limit student choice. We study the Common Application (CA) platform, under which students submit a single application to member schools, potentially reducing frictions and increasing student choice. The CA increases the number of applications received by schools, reflecting a reduction in frictions, and reduces the yield on accepted students, reflecting increased choice. The CA increases out-of-state enrollment, especially from other CA states, consistent with network effects. Entry into the CA changes the composition of students, with evidence of more racial diversity and more high-income students and imprecise evidence of increases in SAT scores. (JEL I23, I28)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"46 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moonlighting is increasingly popular in OECD countries, with 5 to 10 percent of workers holding two or more jobs. However, little is known about the responsiveness of moonlighting to financial incentives due to the lack of identifying variation. This paper studies a unique reform in Germany that allowed workers to hold small secondary jobs tax-free, decreasing the marginal tax rate by between 19.5 to 66 pp. I show that the reform resulted in a dramatic increase in moonlighting that was not offset by reductions in primary earnings and that hours constraints are a key determinant of moonlighting. (JEL H24, H31, J22, J31)
{"title":"Increasing Hours Worked: Moonlighting Responses to a Large Tax Reform","authors":"Alisa Tazhitdinova","doi":"10.1257/pol.20190786","DOIUrl":"https://doi.org/10.1257/pol.20190786","url":null,"abstract":"Moonlighting is increasingly popular in OECD countries, with 5 to 10 percent of workers holding two or more jobs. However, little is known about the responsiveness of moonlighting to financial incentives due to the lack of identifying variation. This paper studies a unique reform in Germany that allowed workers to hold small secondary jobs tax-free, decreasing the marginal tax rate by between 19.5 to 66 pp. I show that the reform resulted in a dramatic increase in moonlighting that was not offset by reductions in primary earnings and that hours constraints are a key determinant of moonlighting. (JEL H24, H31, J22, J31)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"60 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We exploit changes in the discontinuity in health insurance coverage at age 65 induced by the implementation of the Affordable Care Act to examine effects on coverage, hospital use, and patient health. We then link these changes to effects on hospital finances. We show that a substantial share of the federally funded Medicaid expansion substituted for existing locally funded safety net programs. Despite this offset, the expansion produced a substantial increase in hospital revenue, reflected in an equivalent increase in operating surplus. We do not detect improvements in patient mortality, although the expansion led to substantially greater hospital and emergency room use. (JEL H51, H75, I12, I13, I18, I38)
我们利用《平价医疗法案》(Affordable Care Act)实施导致的65岁人群健康保险覆盖面中断的变化，来检查对覆盖面、医院使用和患者健康的影响。然后，我们将这些变化与对医院财务的影响联系起来。我们表明，联邦资助的医疗补助扩张中有相当大的份额取代了现有的地方资助的安全网计划。尽管有这种抵销，但扩建使医院收入大幅增加，反映在营业盈余的相应增加上。我们没有发现病人死亡率的改善，尽管扩建导致医院和急诊室的使用大大增加。(jel h51, h75, i12, i13, i18, i38)
{"title":"The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector","authors":"Mark Duggan, Atul Gupta, Emilie Jackson","doi":"10.1257/pol.20190279","DOIUrl":"https://doi.org/10.1257/pol.20190279","url":null,"abstract":"We exploit changes in the discontinuity in health insurance coverage at age 65 induced by the implementation of the Affordable Care Act to examine effects on coverage, hospital use, and patient health. We then link these changes to effects on hospital finances. We show that a substantial share of the federally funded Medicaid expansion substituted for existing locally funded safety net programs. Despite this offset, the expansion produced a substantial increase in hospital revenue, reflected in an equivalent increase in operating surplus. We do not detect improvements in patient mortality, although the expansion led to substantially greater hospital and emergency room use. (JEL H51, H75, I12, I13, I18, I38)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"59 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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