Institutional Affiliation: University of Pennsylvania
|The Impact of the Affordable Care Act: Evidence from California's Hospital Sector|
with Mark Duggan, Emilie Jackson: w25488
The Affordable Care Act (ACA) authorized the largest expansion of public health insurance in the U.S. since the mid-1960s. We exploit ACA-induced changes in the discontinuity in coverage at age 65 using a regression discontinuity based design to examine effects of the expansion on health insurance 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 and profitability, with larger gains for government hospitals. On the benefits side, we do not detect significant improvements in patient health, although the expansion led ...
|Is American Pet Health Care (Also) Uniquely Inefficient?|
with Liran Einav, Amy Finkelstein: w22669
We document four similarities between American human healthcare and American pet care: (i) rapid growth in spending as a share of GDP over the last two decades; (ii) strong income-spending gradient; (iii) rapid growth in the employment of healthcare providers; and (iv) similar propensity for high spending at the end of life. We speculate about possible implications of these similar patterns in two sectors that share many common features but differ markedly in institutional features, such as the prevalence of insurance and of public sector involvement.
Published: Liran Einav & Amy Finkelstein & Atul Gupta, 2017. "Is American Pet Health Care (Also) Uniquely Inefficient?," American Economic Review, vol 107(5), pages 491-495.