"Gatekeeper" (Judge, Physician) Fixed Effects: Recent Applications

Paper Session

Friday, Jan. 6, 2017 10:15 AM – 12:15 PM

Hyatt Regency Chicago, Field
Hosted By: Econometric Society
  • Chair: Joseph John Doyle, Massachusetts Institute of Technology

Returns to Medicare Spending: Evidence From Variation Across Physicians

Joseph John Doyle
,
Massachusetts Institute of Technology
Amanda Ellen Kowalski
,
Yale University
Heidi Williams
,
Massachusetts Institute of Technology

Abstract

Whether the benefits of medical spending exceed their costs is a key policy question, especially given the government's large and expanding role in the health care sector. In this paper, we investigate whether a natural source of variation in treatment intensity -- namely, the wide variation in treatment intensity across physicians within hospitals -- can be credibly used to estimate the returns to medical care. Our empirical approach integrates two key ideas. First, we focus on patients with “new” conditions, who are more plausibly quasi-randomly assigned to physicians. Second, we empirically identify hospitals in which the assignment of patients to physicians appears to be uncorrelated with baseline patient covariates. For the case of heart attack patients, we establish that this empirical approach appears to provide valid estimates of the returns to medical spending, which we estimate to be on the order of $200,000 per year of life saved.

Households and Incarceration in the United States

Michael Mueller-Smith
,
University of Michigan

Abstract

This paper examines the effect of incarceration on fertility, family structure and the intergenerational transmission of criminal activity in the United States. Random assignment of defendants in Harris County, Texas to criminal courtrooms which hold significant discretion over their court proceeding serves as the basis for identifying exogenous variation in the likelihood of incarceration. The studied outcomes rely on a novel approach to measuring family linkages and household structure based on probabilistic matching applied to several sources of administrative records including marriage, divorce, birth and driver's license records.

Joint Custody and Family Outcomes

Petra Persson
,
Stanford University
Maya Rossin-Slater
,
University of California-Santa Barbara
Miriam Wust
,
Danish National Centre for Social Research

Abstract

Relative to just several decades ago, children in Western families today are much more likely to grow up without both parents in the household. This research project aims to provide some of the first causal evidence on the consequences of an intervention into children's living arrangements for such families. Specifically, we will examine the causal effects of joint custody by leveraging the fact that joint custody cases are randomly assigned to judges in Danish courts, and using variation in judge propensity to rule in favor of joint custody to identify its effects. We use administrative data from Denmark that contains information on random judge assignment, custody decisions, parental background and child and parent outcomes. We study both parents' family formation and labor market behavior, as well as the mental and physical health of parents and children.
JEL Classifications
  • A1 - General Economics