Healthcare

Much of lifetime healthcare spending is concentrated at the end of life. This paper uses survey data linked to administrative hospital and mortality records to examine how the pattern of end-of-life hospital inpatient spending varies across different groups within a large public hospital system in England.

We study insurers' use of prescription drug formularies to screen consumers in the ACA Health Insurance exchanges. We begin by showing that exchange risk adjustment and reinsurance succeed in neutralizing selection incentives for most, but not all, consumer types. A minority of consumers, identifiable by demand for particular classes of prescription drugs, are predictably unprofitable. We then show that contract features relating to these drugs are distorted in a manner consistent with multidimensional screening. The empirical findings support a long theoretical literature examining how insurance contracts offered in equilibrium can fail to optimally trade off risk protection and moral hazard.

Alcohol consumption is associated with costs to society from anti-social behaviour, crime and public costs of policing and health care. These externalities are non-linear in alcohol consumption, with a small number of heavy drinkers creating the majority of the costs. Governments attempt to reduce problematic alcohol consumption through restricting availability and with policies that aim to increase prices. In this paper we study the design of alcohol taxes.

In England, state support for older people with disabilities consists of a national system of non‐means‐tested cash disability benefits and a locally administered means‐tested system of social care. Evidence on how the combination of the two systems targets those in most need is lacking. We estimate a latent factor structural equation model of disability and receipt of one or both forms of support. The model integrates the measurement of disability and its influence on receipt of state support, allowing for the socio‐economic gradient in disability, and adopts income and wealth constructs appropriate to each part of the model.

Changes in health and wellbeing in the years leading up to a cancer diagnosis: a prospective cohort study

In this review, we document end-of-life medical spending: its level, composition, funding, and contribution to aggregate medical spending. We discuss how end-of-life expenses affect household behavior and economic evidence on the efficacy of medical spending at the end of life. Finally, we document recent trends in health and chronic disease at older ages and discuss what they might imply for end-of-life spending and medical spending in the aggregate.

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