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The link between public and private insurance and HIV-related mortality

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  • Bhattacharya, Jayanta
  • Goldman, Dana
  • Sood, Neeraj

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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Suggested Citation

  • Bhattacharya, Jayanta & Goldman, Dana & Sood, Neeraj, 2003. "The link between public and private insurance and HIV-related mortality," Journal of Health Economics, Elsevier, vol. 22(6), pages 1105-1122, November.
  • Handle: RePEc:eee:jhecon:v:22:y:2003:i:6:p:1105-1122
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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.
    2. 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 967-976, July.
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    4. 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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    6. 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.
    7. 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.
    8. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
    9. Dana P. Goldman, 1995. "Managed Care as a Public Cost-Containment Mechanism," RAND Journal of Economics, The RAND Corporation, vol. 26(2), pages 277-295, Summer.
    10. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
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    Cited by:

    1. Qin, Xuezheng & Pan, Jay & Liu, Gordon G., 2014. "Does participating in health insurance benefit the migrant workers in China? An empirical investigation," China Economic Review, Elsevier, vol. 30(C), pages 263-278.
    2. Dana Goldman & Nicole Maestas, 2013. "Medical Expenditure Risk And Household Portfolio Choice," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(4), pages 527-550, June.
    3. Dana Goldman & Nicole Maestas, 2013. "Medical Expenditure Risk And Household Portfolio Choice," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(4), pages 527-550, June.
    4. Philipson Tomas J & Jena Anupam B, 2006. "Who Benefits from New Medical Technologies? Estimates of Consumer and Producer Surpluses for HIV/AIDS Drugs," Forum for Health Economics & Policy, De Gruyter, vol. 9(2), pages 1-33, January.
    5. Neeraj Sood & Yanyu Wu, 2013. "The Impact of Insurance and HIV Treatment Technology on HIV Testing," NBER Working Papers 19397, National Bureau of Economic Research, Inc.
    6. repec:eee:jhecon:v:57:y:2018:i:c:p:168-178 is not listed on IDEAS
    7. Duggan Mark G & Evans William N, 2008. "Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral Treatments," Forum for Health Economics & Policy, De Gruyter, vol. 11(2), pages 1-39, January.
    8. Neeraj Sood & Zachary Wagner & Yanyu Wu, 2015. "The Impact of Insurance on HIV Testing," American Journal of Health Economics, MIT Press, vol. 1(4), pages 515-536, Fall.
    9. Kelaher, Margaret & Jessop, Dorothy Jones, 2006. "The impact of loss of Medicaid on health service utilization among persons with HIV/AIDS in New York City," Health Policy, Elsevier, vol. 76(1), pages 80-92, March.
    10. PAN, Jay & QIN, Xuezheng & LIU, Gordon G., 2013. "The impact of body size on urban employment: Evidence from China," China Economic Review, Elsevier, vol. 27(C), pages 249-263.
    11. repec:eee:jhecon:v:53:y:2017:i:c:p:17-37 is not listed on IDEAS

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    JEL classification:

    • I0 - Health, Education, and Welfare - - General

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