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The Link Between Public and Private Insurance and HIV-Related Mortality

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Author Info
Jay Bhattacharya
Dana Goldman
Neeraj Sood

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Abstract

As policymakers consider expanding insurance coverage for HIV+ individuals, it is useful to ask if insurance has any affect on health outcomes; and, if so, whether public insurance is as efficacious as private insurance in preventing premature deaths among HIV+ patients. Using data from a nationally representative cohort of HIV-infected persons receiving regular medical care, we estimate the impact of different types of insurance on mortality in this population. We find that ignoring observed and unobserved health status leads one to conclude (misleadingly) that insurance may not be protective for HIV patients. After accounting for observed and unobserved heterogeneity, insurance does protect against premature death, but private insurance is more effective than public coverage. The better outcomes associated with private insurance are attributable to the more restrictive prescription drug policies of Medicaid.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 9346.

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Date of creation: Nov 2002
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Handle: RePEc:nbr:nberwo:9346

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I0 - Health, Education, and Welfare - - General

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References listed on IDEAS
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  1. Mroz, Thomas A., 1999. "Discrete factor approximations in simultaneous equation models: Estimating the impact of a dummy endogenous variable on a continuous outcome," Journal of Econometrics, Elsevier, vol. 92(2), pages 233-274, October. [Downloadable!] (restricted)
  2. James J. Heckman, 2001. "Micro Data, Heterogeneity, and the Evaluation of Public Policy: Nobel Lecture," Journal of Political Economy, University of Chicago Press, vol. 109(4), pages 673-748, August. [Downloadable!] (restricted)
  3. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
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  4. Kate Bundorf, M., 2002. "Employee demand for health insurance and employer health plan choices," Journal of Health Economics, Elsevier, vol. 21(1), pages 65-88, January. [Downloadable!] (restricted)
  5. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April. [Downloadable!] (restricted)
  6. Nelson, Charles R & Startz, Richard, 1990. "Some Further Results on the Exact Small Sample Properties of the Instrumental Variable Estimator," Econometrica, Econometric Society, vol. 58(4), pages 967-76, July. [Downloadable!] (restricted)
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  1. Dana P. Goldman & Nicole Maestas, 2007. "Medical Expenditure Risk and Household Portfolio Choice," Working Papers 325-1, RAND Corporation Publications Department. [Downloadable!]
  2. Tomas J. Philipson & Anupam B. Jena, 2005. "Who Benefits from New Medical Technologies? Estimates of Consumer and Producer Surpluses for HIV/AIDS Drugs," NBER Working Papers 11810, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Mark G. Duggan & William N. Evans, 2005. "Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral Treatments," NBER Working Papers 11109, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Dana Goldman & Nicole Maestas, 2005. "Medical Expenditure Risk and Household Portfolio Choice," NBER Working Papers 11818, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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