The Labor-Market Effects of Introducing National Health Insurance: Evidence from Canada

Gruber, Jonathan; Hanratty, Maria J.

doi:10.2307/1392370

Cited by 32 publications

(31 citation statements)

References 12 publications

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“…Health insurance may increase employment overall by improving health and reducing the work disincentive from other means-tested public assistance programs, which may also result in increased labor productivity. In line with this prediction, Gruber and Hanratty (1995) find that employment increased in Canada after the introduction of national health insurance. Additionally, studies examining the introduction of the U.S. continuation-of-coverage mandates, such as COBRA (e.g.…”

Section: Introductionsupporting

confidence: 65%

“…Additionally, studies examining the introduction of the U.S. continuation-of-coverage mandates, such as COBRA (e.g. Gruber and Madrian 1995), find resulting increases in job switching. By de-linking health insurance and employment (but not increasing income, since recipients must pay their own health premiums), these mandates may increase productivity not only by improving health but by enabling improved job matches, that is, reducing “job-lock” 1…”

Section: Introductionmentioning

confidence: 99%

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Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion

Boyle

Lahey

2010

Journal of Public Economics

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This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we employ a difference-in-differences strategy to compare the labor market behavior of older veterans and non-veterans before and after the VA health benefits expansion to test the impact of public health insurance on labor supply. We find that older workers are significantly more likely to decrease work both on the extensive and intensive margins after receiving access to non-employer based insurance. Workers with some college education or a college degree are more likely to transition into self-employment, a result consistent with “job-lock” effects. However, less-educated workers are more likely to leave self-employment, a result suggesting that the positive income effect from receiving public insurance dominates the “job-lock” effect for these workers. Some relatively disadvantaged sub-populations may also increase their labor supply after gaining greater access to public insurance, consistent with complementary positive health effects of health care access or decreased work disincentives for these groups. We conclude that this reform has affected employment and retirement decisions, and suggest that future moves toward universal coverage or expansions of Medicare are likely to have significant labor market effects.

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Section: Introductionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion

Boyle

Lahey

2010

Journal of Public Economics

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“…An informal yet intuitive test of reverse causality based on that proposed by Gruber and Hanratty (1995) in a similar modelling exercise is to include in each of our three models two lead dummy variables, the first indicating whether a FFS method will be adopted the following year, and the other indicating whether a PBP arrangement will be introduced in the following year. If, in our models, causality goes from the provider payment method in place to the outcome variable, the coefficients on the lead dummies will be zero.…”

Section: Testing For Reverse Causalitymentioning

confidence: 99%

System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia

Moreno‐Serra

Wagstaff

2010

Journal of Health Economics

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While there is broad agreement that the way that health care providers are paid affects their performance, the empirical literature on the impacts of provider payment reforms is surprisingly thin. During the 1990s and early 2000s, many European and Central Asian (ECA) countries shifted from paying hospitals through historical budgets to fee-for-service (FFS) or patient-based payment (PBP) methods (mostly variants of diagnosis-related groups, or DRGs). Using panel data on 28 countries over the period 1990-2004, we exploit the phased shift from historical budgets to explore aggregate impacts on hospital throughput, national health spending, and mortality from causes amenable to medical care. We use a regression version of difference-in-differences (DID) and two variants that relax the DID parallel trends assumption. We find that FFS and PBP both increased national health spending, including private (i.e. out-of-pocket) spending. However, they had different effects on inpatient admissions (FFS increased them; PBP had no effect), and average length of stay (FFS had no effect; PBP reduced it). Of the two methods, only PBP appears to have had any beneficial effect on "amenable mortality", but we found significant impacts for only a couple of causes of death, and not in all model specifications.

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“…An informal yet intuitive test of reverse causality based on that proposed by Gruber and Hanratty (1995) in a similar modeling exercise is to include in each of our three models a lead dummy variable indicating whether SHI will be adopted the following year. If causality goes from SHI to the outcome variable, the coefficient on the lead dummy will be zero.…”

Section: Testing For Reverse Causalitymentioning

confidence: 99%

Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes

Wagstaff

Moreno‐Serra

2009

Journal of Health Economics

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The Labor-Market Effects of Introducing National Health Insurance: Evidence from Canada

Abstract: While National Health Insurance (NHI) We examine monthly data on employment, wages, and hours across 8 industries and 10 provinces over the 1961-1975 period. We find that employment actually rose after the introduction of NHI; wages increased as well, while average hours were unchanged.

Cited by 32 publications

References 12 publications

Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion

Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion

System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia

Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes

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