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State and self investments in health

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  • Fichera1, E
  • Sutton, M

Abstract

We consider how individuals' decisions on their health behaviours depend on the level of investment in their health provided by the State. We develop the model provided by Ehrlich and Becker (1972) and Peltzman (1975) and we show that higher levels of protection provided by the State (either through the increased availability or effectiveness of medical care) can crowd out or reinforce self-insurance. We apply this model to the smoking cessation decision made by individuals diagnosed with a cardiovascular disease in waves of the Health Survey of England between 1993 and 2006. There has been a considerable increase in the proportion of these individuals who receive prescriptions of statins from the State, a highly effective drug that reduces the probability of further heart attacks and premature death. We nd that the probability of quitting smoking is increased by four percentage points amongst those individuals prescribed statins. This result is robust to allowing for the direct effects of smoking advice. When the potential endogeneity of doctors' decision to prescribe statins is dealt with using variables in national guidelines, we find that unobservable characteristics which make people more prone to stop smoking reduce the probability of receiving statins and the evidence of the complementarity between quitting smoking and prescription of statins is confirmed.

Suggested Citation

  • Fichera1, E & Sutton, M, 2010. "State and self investments in health," Health, Econometrics and Data Group (HEDG) Working Papers 10/23, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:10/23
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    References listed on IDEAS

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    1. de Preux, L, 2010. "Ex Ante Moral Hazard and Anticipatory Behaviour: Some Evidence," Health, Econometrics and Data Group (HEDG) Working Papers 10/13, HEDG, c/o Department of Economics, University of York.
    2. Christophe Courbage & Augustin de Coulon, 2004. "Prevention and Private Health Insurance in the U.K," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 719-727, October.
    3. Takeshi Amemiya, 1975. "Qualitative Response Models," NBER Chapters,in: Annals of Economic and Social Measurement, Volume 4, number 3, pages 363-372 National Bureau of Economic Research, Inc.
    4. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    5. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    6. Scott, Anthony & Shiell, Alan & King, Madeleine, 1996. "Is general practitioner decision making associated with patient socio-economic status?," Social Science & Medicine, Elsevier, vol. 42(1), pages 35-46, January.
    7. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    8. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-648, July-Aug..
    9. Vassilis A. Hajivassiliou & Daniel L. McFadden, 1998. "The Method of Simulated Scores for the Estimation of LDV Models," Econometrica, Econometric Society, vol. 66(4), pages 863-896, July.
    10. Laure B. de Preux, 2011. "Anticipatory ex ante moral hazard and the effect of medicare on prevention," Health Economics, John Wiley & Sons, Ltd., vol. 20(9), pages 1056-1072, September.
    11. Jones, Andrew M., 1994. "Health, addiction, social interaction and the decision to quit smoking," Journal of Health Economics, Elsevier, vol. 13(1), pages 93-110, March.
    12. Wilde, Joachim, 2000. "Identification of multiple equation probit models with endogenous dummy regressors," Economics Letters, Elsevier, vol. 69(3), pages 309-312, December.
    13. Goddard, Maria & Smith, Peter, 2001. "Equity of access to health care services: : Theory and evidence from the UK," Social Science & Medicine, Elsevier, vol. 53(9), pages 1149-1162, November.
    14. Peltzman, Sam, 1975. "The Effects of Automobile Safety Regulation," Journal of Political Economy, University of Chicago Press, vol. 83(4), pages 677-725, August.
    15. David Roodman, 2009. "Estimating Fully Observed Recursive Mixed-Process Models with cmp," Working Papers 168, Center for Global Development.
    16. G. S. Maddala & Lung-Fei Lee, 1976. "Recursive Models with Qualitative Endogenous Variables," NBER Chapters,in: Annals of Economic and Social Measurement, Volume 5, number 4, pages 525-545 National Bureau of Economic Research, Inc.
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    Citations

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    Cited by:

    1. Fichera, Eleonora & Emsley, Richard & Sutton, Matt, 2016. "Is treatment “intensity” associated with healthier lifestyle choices? An application of the dose response function," Economics & Human Biology, Elsevier, vol. 23(C), pages 149-163.
    2. John Mullahy, 2011. "Marginal Effects in Multivariate Probit and Kindred Discrete and Count Outcome Models, with Applications in Health Economics," NBER Working Papers 17588, National Bureau of Economic Research, Inc.
    3. Paul Andres Rodriguez-Lesmes, 2017. "Early diagnosis of chronic conditions and lifestyle modification," DOCUMENTOS DE TRABAJO 015639, UNIVERSIDAD DEL ROSARIO.
    4. Eleonora Fichera & James Banks & Matt Sutton, 2014. "Health behaviours and the patient-doctor interaction: The double moral hazard problem," The School of Economics Discussion Paper Series 1415, Economics, The University of Manchester.
    5. Fichera, Eleonora & Banks, James & Siciliani, Luigi & Sutton, Matt, 2017. "Does Patient Health Behaviour respond to Doctor’s Effort?," Department of Economics Working Papers 58124, University of Bath, Department of Economics.
    6. Mullahy, John, 2011. "Marginal Effects in Multivariate Probit and Kindred Discrete and Count Outcome Models," Working Papers 201135, Geary Institute, University College Dublin.
    7. Fichera, Eleonora & Gray, Ewan & Sutton, Matt, 2016. "How do individuals’ health behaviours respond to an increase in the supply of health care? Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 159(C), pages 170-179.
    8. Giovanni Bruno & Orietta Dessy, 2014. "Average partial effects in multivariate probit models with latent heterogeneity: Monte Carlo experiments and an application to immigrants' ethnic identity and economic performance," Italian Stata Users' Group Meetings 2014 10, Stata Users Group.

    More about this item

    Keywords

    Crowding-out; moral hazard; preventative behaviour; drugs;

    JEL classification:

    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • D01 - Microeconomics - - General - - - Microeconomic Behavior: Underlying Principles
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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