Essays In Health Economics

Abstract

My first essay examines the relationship between medical innovation and moral hazard. I examine the behavioral response to one recent medical innovation: the Human Papillomavirus (HPV) vaccine. I use both medical claims and survey data to observe a comprehensive set of variables indicating risky behavior. I use instrumental variables and regression discontinuity designs to account for selection into vaccination and to determine the causal effect of receiving the vaccine on behavior and I find evidence of heterogeneous treatment effects. Results indicate that receiving the vaccine leads to moral hazard in low income adolescents; however the vaccine leads to a reduction in risky behavior in the overall population. My second essay is joint work with John Cawley. We use the American Time Use Survey to examine socioeconomic differences in waiting times. Socioeconomic characteristics are correlated with waiting time for medical care. Low income and publicly insured individuals wait longer than higher income groups and those with private coverage. It could be that lower income respondents are getting care without an appointment or that they experience a lower opportunity cost of time than high income respondents and are therefore showing up earlier to appointments. My third essay is also joint work with John Cawley, we examine the relationship between macroeconomic conditions and health. The majority of previous work on the relationship between economic conditions and health focuses on three categories of outcomes: mortality, health and wellbeing measures and health behaviors. We contribute to the large body of empirical work on the relationship between iii macroeconomic conditions and health by examining a range of behaviors via the American Time Use Survey that provide evidence about both the local labor market effect on the opportunity cost of time-intensive health investments. These health-related behaviors provide evidence about the mechanisms driving the relationship between the macroeconomy and health outcomes. We find that time spent in transit is reduced when the local unemployment rate increases and time spent sleeping increases. We also find mixed evidence on diet and exercise-related activities as well as risky behaviors. iv