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The Effects of Private Insurance on Measures of Health: Evidence from the Health and Retirement Study

Author

Listed:
  • Avi Dor
  • Joseph Sudano
  • David W. Baker

Abstract

In this paper we investigate whether the presence of private insurance leads to improved health status. Using the Health and Retirement study we focus on adults in late middle age who are nearing entry into Medicare. Estimation addresses endogeneity of the insurance participation decision in health outcome regressions. Two models are tested, an instrumental variables models, and a model with endogenous treatment effects due to Heckman (1978). Insurance participation and health behaviors enter with a lag to allow their effects to dissipate over time. Separate regressions were run for groupings of chronic conditions. We find that the overall impact of insurance on health tends to be significantly downwards biased if no adjustment for endogeneity is made. With corrections there is a four-fold increase in the insurance effect; yielding a 7 percent increase in the overall health measure for the uninsured. Results are consistent across IV and treatment effects models, and for all major groupings of medical conditions. Thus, the effect of private insurance on health may be larger than previously estimated. As for policy, expanding coverage to the uninsured should result in substantial health improvement. By conjecture, this is likely to reduce the need for health care when individuals retire and enter Medicare, potentially leading to savings.

Suggested Citation

  • Avi Dor & Joseph Sudano & David W. Baker, 2003. "The Effects of Private Insurance on Measures of Health: Evidence from the Health and Retirement Study," NBER Working Papers 9774, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9774
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    References listed on IDEAS

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    1. Michael Baker & Mark Stabile & Catherine Deri, 2004. "What Do Self-Reported, Objective, Measures of Health Measure?," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
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    3. Robert Kaestner & Theodore Joyce & Andrew Racine, 1999. "Does Publicly Provided Health Insurance Improve the Health of Low-Income Children in the United States," NBER Working Papers 6887, National Bureau of Economic Research, Inc.
    4. Susan Averett & Sanders Korenman, 1996. "The Economic Reality of the Beauty Myth," Journal of Human Resources, University of Wisconsin Press, vol. 31(2), pages 304-330.
    5. Vella, Francis & Verbeek, Marno, 1999. "Estimating and Interpreting Models with Endogenous Treatment Effects," Journal of Business & Economic Statistics, American Statistical Association, vol. 17(4), pages 473-478, October.
    6. Kenkel, Donald S, 1991. "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy, University of Chicago Press, vol. 99(2), pages 287-305, April.
    7. Heckman, James J, 1978. "Dummy Endogenous Variables in a Simultaneous Equation System," Econometrica, Econometric Society, vol. 46(4), pages 931-959, July.
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    10. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Publishing House "SINERGIA PRESS", vol. 31(3), pages 129-137.
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    12. T. D. McBride, "undated". "Uninsured Spells of the Poor: Prevalence and Duration," Institute for Research on Poverty Discussion Papers 1131-97, University of Wisconsin Institute for Research on Poverty.
    13. Victor R. Fuchs, 2001. "The Financial Problems of the Elderly: A Holistic Approach," NBER Working Papers 8236, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Beth J. Soldo & Olivia S. Mitchell & Rania Tfaily & John F. McCabe, 2006. "Cross-Cohort Differences in Health on the Verge of Retirement," NBER Working Papers 12762, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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