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Title: Three Essays in Healthcare Economics and Policy Analysis
Citation Type: Dissertation/Thesis
Publication Year: 2022
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Abstract: This dissertation research consists of three essays on healthcare economics and policy analysis. Chapter 1 investigates and explains the failure of a proposition on limiting dialysis clinic profits in California in 2018. The proposition would have required dialysis clinics to issue refunds to patients or their payers for revenue that exceeds 115% of the direct cost of treatment. In this chapter, a conceptual framework of how voters weigh costs and benefits is developed and two different empirical approaches, simple OLS and Double Post LASSO, are employed to identify key determinants of the voting outcome. The empirical results suggest that counties with the presence of the giant dialysis chain, DaVita, are 5% less likely to support the proposition. Chapter 2 estimates the effect of retirement on weight change and prevalence to obesity among different groups of people using 13 waves of Health and Retirement survey data (RAND HRS) from 1992 to 2016. Retirees and working people are very different in their characteristics, especially, physical health. Retirees normally have poorer health outcomes compared to working people due to age and health conditions. Thus, possible selection bias and confounding bias need to be addressed when examining the causal effect of retirement on weight outcomes and prevalence to obesity. Fuzzy Regression Discontinuity Design (Fuzzy RDD) and Propensity Score Matching (PSM) approaches are employed in this chapter to overcome the bias issues. The results suggest that retirement does not have a significant effect on weight outcomes when controlling for selection and confounding biases. Chapter 3 studies the impact of the Affordable Care Act (ACA) on the labor market. The major healthcare reform sparks a debate on whether it could harm employment. The most controversial policy in the ACA is its employer mandate, which requires all employers with 50 or more full-time employees to provide their workers health insurance benefits. The new mandate was predicted to cause a decline in labor demand, hence, put workers into unemployment or involuntary part-time employment. The ACA’s Medicaid expansion was also predicted to cause a decline in labor demand. In this chapter, I use pre-ACA regional uninsured rate as approximation for the region’s degree of exposure the ACA and find that the ACA has positive impact on employment, specially for small businesses, without major obstruction to the country’s business structure.
Url: https://researchrepository.wvu.edu/cgi/viewcontent.cgi?article=12346&context=etd
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Authors: Pham, Tuyen
Institution: West Virginia University
Department: Economics
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Pages: 1-118
Data Collections: IPUMS USA
Topics: Aging and Retirement, Health, Labor Force and Occupational Structure, Population Health and Health Systems, Poverty and Welfare
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