The Medicaid expansions and health insurance subsidies of the Affordable Care Act (ACA) change work incentives for single mothers. To evaluate the employment effects of these policies ex ante, I ...estimate a model of labor supply and health insurance choice exploiting variation in pre-ACA Medicaid policies. Simulations show that single mothers increase their labor supply at the extensive and intensive margin by 12% and 7%, respectively, uninsurance rates decline by up to 40%, and an average family's welfare improves by 1,600 dollars per year. Health insurance subsidies and not Medicaid expansions mostly drive these effects.
We estimate the causal effect of accidents on employment and earnings among Chilean men using event study methods and monthly administrative data. An accident of any type reduces the probability of ...being employed by 8.4 percentage points in the first year, by 11.2 percentage points in the second year, and by 14.8 percentage points in the third year after the accident. On average, over the three years after the accident, employment declines by 14%, relative to the pre‐accident mean. In addition, accidents reduce monthly earnings by around 11% in the first year, 17% in the second year, and 22% in the third year after the accident. On average, monthly earnings fall by 16%, relative to the pre‐accident average. Thus, we estimate persistent and increasing labor market effects of accidents over time. These effects vary by individuals' age, education, and industry and by severity of the accident. Our findings imply that the economic consequences of health shocks go beyond direct medical expenses.
This article proposes bootstrap-based multiple testing procedures for quantile treatment effect (QTE) heterogeneity under the assumption of selection on observables, and shows its asymptotic ...validity. Our procedure can be used to detect the quantiles and subgroups exhibiting treatment effect heterogeneity. We apply the multiple testing procedures to data from a large-scale Pakistani school report card experiment, and uncover evidence of policy-relevant heterogeneous effects from information provision on child test scores. Furthermore, our analysis reinforces the importance of preventing the inflation of false positive conclusions because 63% of statistically significant QTEs become insignificant once corrections for multiple testing are applied.
•How does one spouse's health shock affect the other spouse's employment and earnings?•We answer this theoretically ambiguous question using cancer diagnoses as health shocks.•We combine ...administrative data from the Canadian cancer registry and tax returns.•Men and women are 2.5%-age points less likely to work after their spouses’ diagnoses.•Total family income decreases substantially following one spouse's cancer diagnosis.
Using Canadian administrative data from multiple sources, we provide the first nationally representative estimates for the effect of spouses’ cancer diagnoses on individuals’ employment and earnings and on family income. Our identification strategy exploits unexpected health shocks and combines matching with individual fixed effects in a generalized difference-in-differences framework to control for observable and unobservable heterogeneity. While the effect of spousal health shocks on labor supply is theoretically ambiguous, we find strong evidence for a decline in employment and earnings of individuals whose spouses are diagnosed with cancer. We interpret this result as individuals reducing their labor supply to provide care to their sick spouses and to enjoy joint leisure. Family income substantially declines after spouses’ cancer diagnoses, suggesting that the financial consequences of such health shocks are considerable.
Innovations in cancer treatment have lowered mortality, but little is known about their economic benefits. We assess the effect of two decades of improvement in cancer treatment options on the labor ...market outcomes of breast and prostate cancer patients. In addition, we compare this effect across cancer patients with different levels of educational attainment. We estimate the effect of medical innovation on cancer patients’ labor market outcomes employing tax return and cancer registry data from Canada and measuring medical innovation by using the number of approved drugs and a quality-adjusted patent index. We find that innovations in cancer treatment during the 1990s and 2000s reduced the negative employment effects of cancer by 63% to 70%, corresponding to a reduction in the economic costs of prostate and breast cancer diagnoses by 13,500 and 5800 dollars per year, respectively. The benefits of medical innovation are limited to cancer patients with postsecondary education.
How do patient and provider incentives affect the provision of long-term care? Our analysis of 551,000 nursing home stays yields three main insights. First, due to limited cost-sharing, ...Medicaid-covered residents prolong their nursing home stays instead of transitioning to community-based care. Second, when facility capacity binds, nursing homes shorten Medicaid stays to admit more profitable out-of-pocket private payers. Third, providers react more elastically to financial incentives than patients. Thus, targeting provider incentives through alternative payment models, such as episode-based reimbursement, is more effective than increasing patient cost sharing in facilitating transitions to community-based care and generating long-term care savings. (JEL H51, H75, I11, I13, I18, I38, L84)
A comprehensive theory of the Lamb shift in light muonic atoms such as μH, μD, μ3 He+, and μ4He+ is presented, with all quantum electrodynamic corrections included at the precision level constrained ...by the uncertainty of nuclear structure effects. This analysis can be used in the global adjustment of fundamental constants and in the determination of nuclear charge radii. Further improvements in the understanding of electromagnetic interactions of light nuclei will allow for a promising test of fundamental interactions by comparison with "normal" atomic spectroscopy, in particular, with H-D and 3He − 4He isotope shifts.
Objective
To assess the effects of the Medicare Care Choices Model (MCCM) on disparities in hospice use and quality of end‐of‐life care for Medicare beneficiaries from underserved groups—those from ...racial and ethnic minority groups, dually eligible for Medicare and Medicaid, or living in rural areas.
Data Sources and Study Setting
Medicare enrollment and claims data from 2013 to 2021 for terminally ill Medicare fee‐for‐service beneficiaries nationwide.
Study Design
Through MCCM, terminally ill enrolled Medicare beneficiaries received supportive and palliative care services from hospice providers concurrently with curative treatments. Using a matched comparison group, we estimated subgroup‐specific effects on hospice use, days at home, and aggressive treatment and multiple emergency department visits in the last 30 days of life.
Data Collection/Extraction Methods
The sample included decedent Medicare beneficiaries enrolled in MCCM and a matched comparison group from the same geographic areas who met model eligibility criteria at time of enrollment: having a diagnosis of cancer, congestive heart failure, chronic obstructive pulmonary disease, or HIV/AIDS; living in the community; not enrolled in the Medicare hospice benefit in the previous 30 days; and having at least one hospital stay and three office visits in the previous 12 months.
Principal Findings
Eligible beneficiaries from underserved groups were underrepresented in MCCM. MCCM increased enrollees' hospice use and the number of days at home and reduced aggressive treatment among all subgroups analyzed. MCCM also reduced disparities in hospice use by race and ethnicity and dual eligibility by 4.1 (90% credible interval CI: 1.3–6.1) and 2.4 (90% CI: 0.6–4.4) percentage points, respectively. It also reduced disparities in having multiple emergency department visits for rural enrollees by 1.3 (90% CI: 0.1–2.7) percentage points.
Conclusions
MCCM increased hospice use and quality of end‐of‐life care for model enrollees from underserved groups and reduced disparities in hospice use and having multiple emergency department visits.
Ablation of bulk polycrystalline zinc in air is performed with single and multiple picosecond laser pulses at a wavelength of 1030 nm. The relationships between the characteristics of the ablated ...craters and the processing parameters are analyzed. Morphological changes of the ablated craters are characterized by means of scanning electron microscopy and confocal laser scanning microscopy. Chemical compositions of both the treated and untreated surfaces are quantified with X-ray photoelectron spectroscopy. A comparative analysis on the determination of the ablation threshold using three methods, based on ablated diameter, depth and volume is presented along with associated incubation coefficients. The single pulse ablation threshold value is found to equal 0.21 J/cm
. Using the calculated incubation coefficients, it is found that both the fluence threshold and energy penetration depth show lesser degree of incubation for multiple laser pulses.
Implementing new concepts and measures for flood risk management may be restricted by hydromechanical processes. These processes govern the movement of water masses within rivers and their ...floodplains. Different hydraulic processes are still not fully understood or cannot be described satisfactorily by hydro‐numerical models due to uncertainty in input data. The choosing of the correct surface roughness has a huge influence on the results of hydro‐numerical calculation of historical and design flood events and their reliability for the assessment of flood risk mitigation measures like floodplain restoration. The authors try to outline the various effects of channel and floodplain roughness on fluvial flood routing and give examples. A method is presented for peak discharge calculation of historical flood events.
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