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Modeling health insurance expansions: Effects of alternate approaches

Author

Listed:
  • Dahlia K. Remler

    (Department of Health Policy and Management, Mailman School of Public Health, Columbia University)

  • Joshua Graff Zivin

    (Department of Health Policy and Management, Mailman School of Public Health, Columbia University)

  • Sherry A. Glied

    (Department of Health Policy and Management, Mailman School of Public Health, Columbia University)

Abstract

Estimates of the costs and consequences of many types of public policy proposals play an important role in the development and adoption of particular policy programs. Estimates of the same, or similar, policies that employ different modeling approaches can yield widely divergent results. Such divergence often undermines effective policymaking. These problems are particularly prominent for health insurance expansion programs. Concern focuses on predictions of the numbers of individuals who will be insured and the costs of the proposals. Several different simulation-modeling approaches are used to predict these effects, making the predictions difficult to compare. This paper categorizes and describes the different approaches used; explains the conceptual and theoretical relationships between the methods; demonstrates empirically an example of the (quite restrictive) conditions under which all approaches can yield quantitatively identical predictions; and empirically demonstrates conditions under which the approaches diverge and the quantitative extent of that divergence. All modeling approaches implicitly make assumptions about functional form that impose restrictions on unobservable heterogeneity. Those assumptions can dramatically affect the quantitative predictions made. © 2004 by the Association for Public Policy Analysis and Management.

Suggested Citation

  • Dahlia K. Remler & Joshua Graff Zivin & Sherry A. Glied, 2004. "Modeling health insurance expansions: Effects of alternate approaches," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 23(2), pages 291-313.
  • Handle: RePEc:wly:jpamgt:v:23:y:2004:i:2:p:291-313
    DOI: 10.1002/pam.20005
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    References listed on IDEAS

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    1. Helen F. Ladd, 2002. "School Vouchers: A Critical View," Journal of Economic Perspectives, American Economic Association, vol. 16(4), pages 3-24, Fall.
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    4. Goldman Dana P & Joyce Geoffrey F & Malkin Jesse Dylan, 2002. "The Costs of A Medicare Prescription Drug Benefit," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 2(1), pages 1-18, April.
    5. Derek Neal, 2002. "How Vouchers Could Change the Market for Education," Journal of Economic Perspectives, American Economic Association, vol. 16(4), pages 25-44, Fall.
    6. Sherry Glied & Tama Brooks, 1997. "The Market and the Estimators: Forecasting the Cost of Medicare Catastrophic Coverage," NBER Working Papers 6287, National Bureau of Economic Research, Inc.
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    Citations

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    Cited by:

    1. Jonathan Gruber, 2005. "Tax Policy for Health Insurance," NBER Chapters,in: Tax Policy and the Economy, Volume 19, pages 39-64 National Bureau of Economic Research, Inc.
    2. Gregory J. Colman & Dahlia K. Remler, 2008. "Vertical equity consequences of very high cigarette tax increases: If the poor are the ones smoking, how could cigarette tax increases be progressive?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 27(2), pages 376-400.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • H0 - Public Economics - - General

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