Healthcare and Labor Markets
Paper Session
Friday, Jan. 3, 2025 8:00 AM - 10:00 AM (PST)
- Chair: Cici McNamara, Georgia Institute of Technology
Broadband Internet Access, Economic Growth, and Suicide
Abstract
Between 1999 and 2008, access to high-speed, broadband internet grew significantly in the United States, but there is debate on whether access to high-speed internet improves or harms mental health. We find that a ten percent increase in the proportion of county residents with access to broadband internet leads to a 1.8 percent reduction in the number of suicides in a county, as well as improvements in self-reported mental and physical health. We further find that this reduction in suicide deaths is likely due to economic improvements in counties that have access to broadband internet. Counties with increased access to broadband internet see reductions in poverty rate and unemployment rate. In addition, zip codes that gain access to broadband internet see increases in the numbers of employees and establishments. In addition, heterogeneity analysis indicates that the positive effects are concentrated in the working age population, those between 25 and 64 years old. This pattern is precisely what is predicted by the literature linking economic conditions to suicide risk.Evaluating Substitutes for Antitrust: The Case of COPA Laws
Abstract
Premerger review may prevent the consummation of mergers that antitrust officials consider likely to negatively impact market outcomes. When local and federal regulators' objectives do not align, local regulators may wish to shield merging parties from antitrust scrutiny. Certificate of Public Advantage (COPA) laws substitute antitrust review of hospital mergers for local regulation. Local contracts established under COPA laws vary in their stringency and scope. We use data on hospital merger activity, prices, and labor market outcomes including employment and wages along with a differences-in-differences model to examine the effect of mergers consummated under COPA laws. We couple this with a synthetic differences-in-differences approach that allows us to document significant heterogeneity in merger effects across COPA mergers. Our results allow us to speak to the effects of mergers consummated in the absence of federal antitrust scrutiny and the capacity of regulatory constraints to work as a substitute for antitrust policy.Medicare on the Back Burner? Provider Labor Supply Responses to ACA-Driven Changes in Patient Payer Mix
Abstract
ACA has expanded private insurance coverage to millions of moderate-income American adults. This paper investigates physician discrimination against Medicare in favor of private patients by examining whether such demand shocks from private patients would crowd out physician services to Medicare patients. We find that the ACA private insurance expansion has reduced Medicare appointments by 7.8 percent, or 234 appointments per year per physician, and has decreased physician labor input into treating Medicare patients by 2.9 percent. This leads to total Medicare savings of 4.9 percent, or $5,962 per year per physician. Physicians reduce their care supply to Medicare patients mainly by serving fewer Medicare patients or canceling follow-up visits per Medicare patient. The negative spillover effect mainly occurs among existing, rather than new, Medicare patients. Our findings contribute to the debate on the pros and cons of ACA insurance expansion and the problems associated with the fragmented demand side of healthcare.Does Longest-held Occupation Predict Mortality Risk? Evidence from a 29-year Follow-up Study of Elderly U.S. Adults
Abstract
Occupation is identified as a risk factor for adverse health effects including injury and disease; unhealthy behaviors such as smoking, physical inactivity, and an unhealthy diet; exposure to hazardous chemical and biomechanical factors; and damaging psychosocial impacts. However, not much is known about the association between longest-held occupation (LHO) and early mortality. Objective: We examined if longest-held occupation (LHO) predicts mortality risk among U.S. adults 51 years of age and older. Methods: Using the Health and Retirement Study data from 1992 to 2020, we followed 26,758 respondents 51 years of age and older for up to 29 years. We used competing-risks analysis methodology to estimate the risk of mortality. Results: Across the average 20.5 follow-up years, women with LHO in the categories of machine operators (sub-hazard ratio [SHR]:1.42), food preparation (SHR: 1.39), handlers and helpers (SHR:1.35), and sales (SHR:1.15), were more likely to die earlier than women with the LHO in the professional and technical support occupation, the reference occupation. Men with LHO in the categories of food preparation (SHR:1.43), machine operators (SHR:1.36), personal services (SHR: 1.34), handlers and helpers (SHR:1.32), protective services (SHR:1.31), clerical (SHR:1.27), farming and fishing (SHR:1.26), sales (SHR:1.23), and precision production (SHR: 1.20) had elevated risks of mortality compared to men whose LHO was in the professional and technical support occupation, the reference occupation. Conclusions: Both men and women in food preparation, machine operation, personal services, sales, and handlers and helpers occupations had an elevated risk of early mortality. These findings provide support to a growing body of literature that is building the evidence that occupation can be one of the risk factors for adverse health outcomes, and ultimately for early mortality.Discussant(s)
Lucie Schmidt
,
Smith College
Jiee Zhong
,
Miami University-Ohio
Lynn M. Hua
,
Georgia State University
Danea Horn
,
University of California-San Francisco
Yun Taek Oh
,
University of Nevada-Reno
JEL Classifications
- J4 - Particular Labor Markets