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Health Care Quality and Economic Inequality

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  • Jappelli, Tullio
  • Pistaferri, Luigi
  • Weber, Guglielmo

Abstract

We argue that health care quality has an important impact on economic inequality and on saving behaviour. We exploit district-wide variability in health care quality provided by the Italian universal public health system to identify the effect of quality on income inequality, health inequality and precautionary saving. We find that in lower quality districts there is greater income and health dispersion and higher precautionary saving. The analysis carries important insights for the ongoing debate about the validity of the life-cycle model and interesting policy implications for the design of health care systems.

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Paper provided by C.E.P.R. Discussion Papers in its series CEPR Discussion Papers with number 4542.

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Date of creation: Aug 2004
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Handle: RePEc:cpr:ceprdp:4542

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Keywords: health care; Income inequality; precautionary saving;

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References

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  1. Caballero, Ricardo J., 1990. "Consumption puzzles and precautionary savings," Journal of Monetary Economics, Elsevier, vol. 25(1), pages 113-136, January.
  2. Victor R. Fuchs & Mark B. McClellan & Jonathan S. Skinner, 2004. "Area Differences in Utilization of Medical Care and Mortality among U.S. Elderly," NBER Chapters, in: Perspectives on the Economics of Aging, pages 367-414 National Bureau of Economic Research, Inc.
  3. Christopher D. Carroll & Andrew A. Samwick, 1998. "How Important Is Precautionary Saving?," The Review of Economics and Statistics, MIT Press, vol. 80(3), pages 410-419, August.
  4. Paul Gertler & Jonathan Gruber, 1998. "Insuring Consumption Against Illness," JCPR Working Papers 41, Northwestern University/University of Chicago Joint Center for Poverty Research.
  5. Currie, Janet & Madrian, Brigitte C., 1999. "Health, health insurance and the labor market," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 50, pages 3309-3416 Elsevier.
  6. Guiso, Luigi & Jappelli, Tullio & Terlizzese, Daniele, 1992. "Earnings Uncertainty and Precautionary Saving," CEPR Discussion Papers 699, C.E.P.R. Discussion Papers.
  7. Erich Battistin & Raffaele Miniaci & Guglielmo Weber, 2003. "What Do We Learn from Recall Consumption Data?," Journal of Human Resources, University of Wisconsin Press, vol. 38(2).
  8. Angus S. Deaton & Christina Paxson, 1998. "Health, Income, and Inequality over the Life Cycle," NBER Chapters, in: Frontiers in the Economics of Aging, pages 431-462 National Bureau of Economic Research, Inc.
  9. Jonathan Gruber & Aaron Yelowitz, 1999. "Public Health Insurance and Private Savings," Journal of Political Economy, University of Chicago Press, vol. 107(6), pages 1249-1274, December.
  10. Glenn R. Hubbard & Jonathan Skinner & Stephen P. Zeldes, . "Precautionary Saving and Social Insurance," Rodney L. White Center for Financial Research Working Papers 03-95, Wharton School Rodney L. White Center for Financial Research.
  11. Laurence J. Kotlikoff, 1986. "Health Expenditures and Precautionary Savings," NBER Working Papers 2008, National Bureau of Economic Research, Inc.
  12. Michael Hurd & Arie Kapteyn, 2003. "Health, Wealth, and the Role of Institutions," Working Papers 03-09, RAND Corporation Publications Department.
  13. Palumbo, Michael G, 1999. "Uncertain Medical Expenses and Precautionary Saving Near the End of the Life Cycle," Review of Economic Studies, Wiley Blackwell, vol. 66(2), pages 395-421, April.
  14. Martha Starr-McCluer, 1994. "Health insurance and precautionary saving," Finance and Economics Discussion Series 94-10, Board of Governors of the Federal Reserve System (U.S.).
  15. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408 Elsevier.
  16. Behrman, Jere R & Birdsall, Nancy, 1983. "The Quality of Schooling: Quantity Alone is Misleading," American Economic Review, American Economic Association, vol. 73(5), pages 928-46, December.
  17. Tullio Jappelli & Mario Padula, 2002. "The Quality of Health Care: Evidence from Italy," CSEF Working Papers 84, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
  18. Orazio P. Attanasio & Agar Brugiavini, 2003. "Social Security And Households' Saving," The Quarterly Journal of Economics, MIT Press, vol. 118(3), pages 1075-1119, August.
  19. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
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Cited by:
  1. Massimo Baldini & Gilberto Turati, 2012. "Perceived quality of public services, liquidity constraints, and the demand of private specialist care," Empirical Economics, Springer, vol. 42(2), pages 487-511, April.

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