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Government Intervention in the Markets for Education and Health Care: How and Why?

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Author Info
James M. Poterba

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Abstract

Education and health care are the two largest government expenditure items in the United States. The public sector directly provides the majority of educational services, through the public school bureaucracy, while most public support for health care is channelled through a system of tax-supported government payments for services provided by private providers. The contrast between public policies in these markets raises a host of questions about the scope of government in a mixed economy, and the structure of policies for market intervention. This paper examines how two standard arguments for government intervention in private markets, market failure and redistribution, apply to the markets for education and medical care. It then considers the 'choice of instrument' problem, the choice between intervention via price subsidies, mandates, and direct public provision of services in these markets. Economic arguments alone seem unable to explain the sharp divergence between the nature of public policies with respect to education and medical care. Moreover, there is virtually no evidence on the empirical magnitudes of many of the key parameters needed to guide policy in these areas, such as the social externalities associated with primary and secondary education or the degree to which adverse selection in the insurance market prevents private insurance purchase.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 4916.

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Date of creation: Dec 1995
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Handle: RePEc:nbr:nberwo:4916

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Find related papers by JEL classification:
H10 - Public Economics - - Structure and Scope of Government - - - General
H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

  1. Henry J. Aaron, 1996. "Health Care Reform: The Clash of Goals, Facts, and Ideology," NBER Chapters, in: Individual and Social Responsibility: Child Care, Education, Medical Care, and Long-Term Care in America, pages 107-142 National Bureau of Economic Research, Inc. [Downloadable!]
  2. Laurence J. Kotlikoff & Jagadeesh Gokhale, 1993. "The equity of social services provided to children and senior citizens," Working Paper 9311, Federal Reserve Bank of Cleveland. [Downloadable!]
    Other versions:
  3. Tobin, James, 1970. "On Limiting the Domain of Inequality," Journal of Law & Economics, University of Chicago Press, vol. 13(2), pages 263-77, October.
  4. Gruber, J. & Poterba, J., 1994. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," Working papers 94-10, Massachusetts Institute of Technology (MIT), Department of Economics.
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  5. Rothschild, Michael & Stiglitz, Joseph E, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, MIT Press, vol. 90(4), pages 630-49, November.
  6. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December. [Downloadable!] (restricted)
  7. Vining, Aidan R & Boardman, Anthony E, 1992. " Ownership versus Competition: Efficiency in Public Enterprise," Public Choice, Springer, vol. 73(2), pages 205-39, March.
  8. Aaron, Henry J, 1994. "Issues Every Plan to Reform Health Care Financing Must Confront," Journal of Economic Perspectives, American Economic Association, vol. 8(3), pages 31-43, Summer. [Downloadable!] (restricted)
  9. Sonstelie, Jon, 1982. "The Welfare Cost of Free Public Schools," Journal of Political Economy, University of Chicago Press, vol. 90(4), pages 794-808, August. [Downloadable!] (restricted)
  10. Ballard, Charles L & Shoven, John B & Whalley, John, 1985. "General Equilibrium Computations of the Marginal Welfare Costs of Taxes in the United States," American Economic Review, American Economic Association, vol. 75(1), pages 128-38, March. [Downloadable!] (restricted)
  11. Henderson, Vernon & Mieszkowski, Peter & Sauvageau, Yvon, 1978. "Peer group effects and educational production functions," Journal of Public Economics, Elsevier, vol. 10(1), pages 97-106, August. [Downloadable!] (restricted)
  12. David M. Cutler & Louise M. Sheiner, 1993. "Policy Options for Long-Term Care," NBER Working Papers 4302, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  13. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Oxford University Press, vol. 23(1), pages 21-36, January.
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Hans J. Baumgartner & Viktor Steiner, 2004. "Enrolment into Higher Education and Changes in Repayment Obligations of Student Aid: Microeconometric Evidence for Germany," Discussion Papers of DIW Berlin 444, DIW Berlin, German Institute for Economic Research. [Downloadable!]
    Other versions:
  2. Thomas S. Dee, 2003. "Are There Civic Returns to Education?," NBER Working Papers 9588, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Amy Finkelstein & Robin McKnight, 2005. "What Did Medicare Do (And Was It Worth It)?," NBER Working Papers 11609, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Luciano Greco, 2006. "Optimal Redistribution With Productive Social Services," "Marco Fanno" Working Papers 0026, Dipartimento di Scienze Economiche "Marco Fanno". [Downloadable!]
  5. Liran Einav & Amy Finkelstein & Mark R. Cullen, 2008. "Estimating Welfare in Insurance Markets Using Variation in Prices," NBER Working Papers 14414, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  6. Karen Eggleston & Keqin Rao & Jian Wang, 2005. "From Plan to Market in the Health Sector? China's Experience," Discussion Papers Series, Department of Economics, Tufts University 0501, Department of Economics, Tufts University. [Downloadable!]
    Other versions:
  7. Leonardo Gasparini & Santiago Pinto, 2005. "Equality of Opportunity and Optimal Cash and In-Kind Policies," Working Papers 0022, CEDLAS, Universidad Nacional de La Plata. [Downloadable!]
    Other versions:
  8. Thomas Dee, 2005. "The Effects of Catholic Schooling on Civic Participation," International Tax and Public Finance, Springer, vol. 12(5), pages 605-625, September. [Downloadable!] (restricted)
  9. Andrei Shleifer, 1998. "State Versus Private Ownership," NBER Working Papers 6665, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  10. Hoxby, Caroline Minter, 1996. "Are Efficiency and Equity in School Finance Substitutes or Complements?," Journal of Economic Perspectives, American Economic Association, vol. 10(4), pages 51-72, Fall. [Downloadable!] (restricted)
  11. Eric A. Hanushek, 1998. "Conclusions and controversies about the effectiveness of school resources," Economic Policy Review, Federal Reserve Bank of New York, issue Mar, pages 11-27. [Downloadable!]
  12. Victor R. Fuchs, 1998. "Health, Government, and Irving Fisher," NBER Working Papers 6710, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  13. Rebecca M. Blank, 1999. "When Can Public Policy Makers Rely on Private Markets? The Effective Provision of Social Services," NBER Working Papers 7099, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
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