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The Doctor Might See You Now: The Supply Side Effects of Public Health Insurance Expansions

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  • Craig L. Garthwaite
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    Abstract

    In the United States, public health insurance programs cover over 90 million individuals. Expansions of these programs, such as the recently passed Patient Protection and Affordable Care Act (PPACA), may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program (SCHIP), physicians decreased the number of hours spent with patients, but increased their program participation. Suggestive evidence shows that this decrease resulted from shorter office visits. These findings are consistent with the predictions from a mixed-economy model of physician behavior and provide evidence of crowd out resulting from the creation of SCHIP. (JEL H75, I11, I13, I18)

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    File URL: http://www.aeaweb.org/articles.php?doi=10.1257/pol.4.3.190
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    File URL: http://www.aeaweb.org/aej/pol/data/2010-0242_data.zip
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    Article provided by American Economic Association in its journal American Economic Journal: Economic Policy.

    Volume (Year): 4 (2012)
    Issue (Month): 3 (August)
    Pages: 190-215

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    Handle: RePEc:aea:aejpol:v:4:y:2012:i:3:p:190-215
    Note: DOI: 10.1257/pol.4.3.190
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    Keywords:

    Find related papers by JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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    Cited by:

    1. Thomas C. Buchmueller & Sarah Miller & Marko Vujicic, 2014. "How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits," NBER Working Papers 20053, National Bureau of Economic Research, Inc.
    2. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    3. Stange, Kevin, 2014. "How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants," Journal of Health Economics, Elsevier, vol. 33(C), pages 1-27.
    4. Wagner, Kathryn L., 2016. "Shock, but no shift: Hospitals' responses to changes in patient insurance mix," Journal of Health Economics, Elsevier, vol. 49(C), pages 46-58.
    5. Margaret Triyana, 2016. "Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 255-288, November.
    6. Michael D. Frakes & Matthew B. Frank & Seth A. Seabury, 2017. "The Effect of Malpractice Law on Physician Supply: Evidence from Negligence-Standard Reforms," NBER Working Papers 23446, National Bureau of Economic Research, Inc.
    7. Bronchetti, Erin Todd, 2014. "Public insurance expansions and the health of immigrant and native children," Journal of Public Economics, Elsevier, vol. 120(C), pages 205-219.
    8. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters,in: Economics of Means-Tested Transfer Programs in the United States, volume 1, pages 21-136 National Bureau of Economic Research, Inc.
    9. Johanna Catherine Maclean & Ioana Popovici & Elisheva Rachel Stern, 2017. "Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers," NBER Working Papers 23094, National Bureau of Economic Research, Inc.
    10. Thomas Buchmueller & Sarah Miller & Marko Vujicic, 2016. "How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 70-102, November.
    11. Maclean, J. Catherine & Popovici, Ioana & Stern, Elisheva Rachel, 2017. "Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers," IZA Discussion Papers 10478, Institute for the Study of Labor (IZA).

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