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Mortality and Science: A Comment on Two Articles on the Effects of Health Insurance on Mortality

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  • Robert Kaestner

Abstract

Recently, two studies on the effect of health insurance on mortality were published in the Quarterly Journal of Economics. Both articles provide evidence consistent with the conclusion that obtaining health insurance entirely eliminates mortality. I examine the evidence in each article and conclude that neither provides much useful information. Both investigations are severely under-powered for detecting a reasonably sized effect of health insurance on mortality; both were likely to grossly overestimate the effect, if not get the direction of the effect wrong. In addition, between the two articles there are many inconsistencies and anomalous results that seem inexplicable from a behavioral or clinical perspective. Further, one study was observational and likely biased by unmeasured confounding, and the other has virtually no external validity.

Suggested Citation

  • Robert Kaestner, 2021. "Mortality and Science: A Comment on Two Articles on the Effects of Health Insurance on Mortality," Econ Journal Watch, Econ Journal Watch, vol. 18(2), pages 192–211-1, September.
    • Handle: RePEc:ejw:journl:v:18:y:2021:i:2:p:192-211
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    References listed on IDEAS

    as
    1. Borgschulte, Mark & Vogler, Jacob, 2020. "Did the ACA Medicaid expansion save lives?," Journal of Health Economics, Elsevier, vol. 72(C).
    2. John A. List & Azeem M. Shaikh & Yang Xu, 2019. "Multiple hypothesis testing in experimental economics," Experimental Economics, Springer;Economic Science Association, vol. 22(4), pages 773-793, December.
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    Cited by:

    1. Malani, Anup & Holtzman, Phoebe & Imai, Kosuke & Kinnan, Cynthia & Miller, Morgen & Swaminathan, Shailender & Voena, Alessandra & Woda, Bartek & Conti, Gabriella, 2021. "Effect of Health Insurance in India: A Randomized Controlled Trial," IZA Discussion Papers 14913, Institute of Labor Economics (IZA).
    2. Black, Bernard & Hollingsworth, Alex & Nunes, Letícia & Simon, Kosali, 2022. "Simulated power analyses for observational studies: An application to the Affordable Care Act Medicaid expansion," Journal of Public Economics, Elsevier, vol. 213(C).

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    More about this item

    Keywords

    Medicaid; Medicare; Affordable Care Act; health insurance; external validity; statistical power;
    All these keywords.

    JEL classification:

    • A13 - General Economics and Teaching - - General Economics - - - Relation of Economics to Social Values
    • A14 - General Economics and Teaching - - General Economics - - - Sociology of Economics
    • 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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