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Is There "Too Much" Inequality in Health Spending Across Income Groups?

Author

Listed:
  • Laurence Ales
  • Roozbeh Hosseini
  • Larry E. Jones

Abstract

In this paper we study the efficient allocation of health resources across individuals. We focus on the relation between health resources and income (taken as a proxy for productivity). In particular we determine the efficient level of the health care social safety net for the indigent. We assume that individuals have different life cycle profiles of productivity. Health care increases survival probability. We adopt the classical approach of welfare economics by considering how a central planner with an egalitarian (ex-ante) perspective would allocate resources. We show that, under the efficient allocation, health care spending increases with labor productivity, but only during the working years. Post retirement, everyone would get the same health care. Quantitatively, we find that the amount of inequality across the income distribution in the data is larger that what would be justified solely on the basis of production efficiency, but not drastically so. As a rough summary, in U.S. data top to bottom spending ratios are about 1.5 for most of the life cycle. Efficiency implies a decline from about 2 (at age 25) to 1 at retirement. We find larger inefficiencies in the lower part of the income distribution and in post retirement ages.

Suggested Citation

  • Laurence Ales & Roozbeh Hosseini & Larry E. Jones, 2012. "Is There "Too Much" Inequality in Health Spending Across Income Groups?," NBER Working Papers 17937, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:17937
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    References listed on IDEAS

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    1. Cole, Harold L. & Kim, Soojin & Krueger, Dirk, 2012. "Analyzing the effects of insuring health risks: On the trade-off between short run insurance benefits vs. long run incentive costs," CFS Working Paper Series 2012/18, Center for Financial Studies (CFS).
    2. Laurence Ales & Roozbeh Hosseini & Larry Jones, "undated". "Is There ``Too Much'''' Inequality in Health Spending Across Income Groups?," GSIA Working Papers 2014-E18, Carnegie Mellon University, Tepper School of Business.
    3. Kopecky, Karen A. & Koreshkova, Tatyana, 2010. "The impact of medical and nursing home expenses and social insurance," FRB Atlanta Working Paper 2010-19, Federal Reserve Bank of Atlanta, revised 01 Dec 2013.
    4. Yogo, Motohiro, 2016. "Portfolio choice in retirement: Health risk and the demand for annuities, housing, and risky assets," Journal of Monetary Economics, Elsevier, vol. 80(C), pages 17-34.
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    8. Juergen Jung & Chung Tran, 2010. "Medical Consumption Over the Life Cycle: Facts from a U.S. Medical Expenditure Panel Survey," Discussion Papers 2010-08, School of Economics, The University of New South Wales.
    9. Laurence Ales & Maziero Pricila, "undated". "Accounting for Private Information," GSIA Working Papers 2010-E58, Carnegie Mellon University, Tepper School of Business.
    10. Ehrlich, Isaac & Chuma, Hiroyuki, 1990. "A Model of the Demand for Longevity and the Value of Life Extension," Journal of Political Economy, University of Chicago Press, vol. 98(4), pages 761-782, August.
    11. Maxim Troshkin & Ali Shourideh, 2014. "Providing Efficient Incentives to Work: Retirement Ages and the Pension System," 2014 Meeting Papers 1319, Society for Economic Dynamics.
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    13. Valerie Albouy & Laurent Davezies & Thierry Debrand, 2009. "Dynamic Estimation of Health Expenditure: A new approach for simulating individual expenditure," Working Papers DT20, IRDES institut for research and information in health economics, revised Jan 2009.
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    Cited by:

    1. Harold L. Cole & Soojin Kim & Dirk Krueger, 2012. "Analyzing the Effects of Insuring Health Risks: On the Trade-off between Short Run Insurance Benefits vs. Long Run Incentive Costs," NBER Working Papers 18572, National Bureau of Economic Research, Inc.
    2. Mariacristina De Nardi & Eric French & John Bailey Jones, 2016. "Savings After Retirement: A Survey," Annual Review of Economics, Annual Reviews, vol. 8(1), pages 177-204, October.
    3. Laurence Ales & Roozbeh Hosseini & Larry Jones, "undated". "Is There ``Too Much'''' Inequality in Health Spending Across Income Groups?," GSIA Working Papers 2014-E18, Carnegie Mellon University, Tepper School of Business.
    4. Hosseini, Roozbeh & Shourideh, Ali, 2016. "Retirement Financing: An Optimal Reform Approach," MPRA Paper 71613, University Library of Munich, Germany, revised 19 Jan 2016.
    5. Aisa, Rosa & Larramona, Gemma & Pueyo, Fernando, 2015. "Active aging, preventive health and dependency: Heterogeneous workers, differential behavior," Journal of Economic Behavior & Organization, Elsevier, vol. 117(C), pages 1-9.
    6. Nádia Simões & Nuno Crespo & Sandrina B. Moreira & Celeste A. Varum, 2016. "Measurement and determinants of health poverty and richness: evidence from Portugal," Empirical Economics, Springer, vol. 50(4), pages 1331-1358, June.
    7. Janicki, Hubert P., 2014. "The role of asset testing in public health insurance reform," Journal of Economic Dynamics and Control, Elsevier, vol. 44(C), pages 169-195.
    8. Schön, Matthias, 2015. "Unemployment, Sick Leave and Health," Annual Conference 2015 (Muenster): Economic Development - Theory and Policy 113013, Verein für Socialpolitik / German Economic Association.

    More about this item

    JEL classification:

    • H4 - Public Economics - - Publicly Provided Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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