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Health Economics and Insurance
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Health Economics and Insurance

A special issue of Journal of Risk and Financial Management (ISSN 1911-8074). This special issue belongs to the section "Applied Economics and Finance".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 25093

Special Issue Editor

Dr. James Bailey

E-Mail Website
Guest Editor
Economics Faculty, Providence College, Providence, RI 02918, USA
Interests: health economics; health insurance; labor economics

Special Issue Information

Dear Colleagues,

Healthcare is one of the largest and fastest-growing sectors in many economies, and the quality and availability of health services has an outsized impact on quality of life. Healthcare financing and delivery arrangements vary greatly across countries, providing opportunities for researchers to study the strengths and weaknesses of various health systems and for policymakers to learn from these comparisons.

This Special Issue will cover a variety of topics related to the economics of healthcare and health insurance. Of particular interest are empirical articles evaluating the effect of changes in health policy and regulations, articles on the determinants of healthcare spending or quality, articles developing value-added measures of healthcare quality, and articles studying innovations in managing the financial risks of unexpected health shocks.

Dr. James Bailey
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Risk and Financial Management is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (6 papers)

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Research

21 pages, 351 KiB  
Article
A Mortality Risk Analysis for OSHA’s COVID-19 Emergency Regulations
by James Broughel and Andrew Baxter
J. Risk Financial Manag. 2022, 15(10), 481; https://doi.org/10.3390/jrfm15100481 - 21 Oct 2022
Cited by 2 | Viewed by 1877
Abstract
In 2021, the Occupational Safety and Health Administration (OSHA) issued two emergency temporary standard regulations related to COVID-19 hazards in US workplaces. One regulation covered healthcare sector workers, while the second regulation would have covered workers at firms with 100 or more employees. [...] Read more.
In 2021, the Occupational Safety and Health Administration (OSHA) issued two emergency temporary standard regulations related to COVID-19 hazards in US workplaces. One regulation covered healthcare sector workers, while the second regulation would have covered workers at firms with 100 or more employees. This paper conducts an original mortality risk analysis for these regulations. Mortality risk analysis evaluates the increase or decrease in expected mortality associated with a new policy, such as a rule or regulation, taking into account economic factors like lost income due to regulatory costs. If we accept OSHA’s cost and health benefit estimates at face value, we find that the first regulation related to COVID-19 hazards in the healthcare sector reduces risk initially but increases risk over a longer time horizon. We find that the second regulation would reduce risk according to OSHA’s main estimates but may not reduce risk after including some ancillary costs and adjusting the agency’s prevented hospitalizations estimate based on more reasonable assumptions. Moreover, OSHA’s economic analysis for the two regulations in question does not purport to comprehensively evaluate costs; ergo, our mortality risk estimates probably underestimate countervailing mortality risks stemming from these regulations. We review some of OSHA’s underlying assumptions that could change the outcomes of our mortality analysis. These estimates demonstrate that OSHA would benefit from more comprehensive consideration of costs in its economic analysis. Full article
(This article belongs to the Special Issue Health Economics and Insurance)
12 pages, 756 KiB  
Article
Health Insurance Patterns of Older Veterans: Evidence from the Health and Retirement Study
by Amanda C. Stype
J. Risk Financial Manag. 2022, 15(8), 333; https://doi.org/10.3390/jrfm15080333 - 28 Jul 2022
Cited by 2 | Viewed by 1822
Abstract
With the increased availability of community care to veterans from the VA MISSION Act, policymakers and providers need to understand how older veterans are insured, particularly before Medicare eligibility at age 65. Using data from 1996 to 2018, this study examines the insurance [...] Read more.
With the increased availability of community care to veterans from the VA MISSION Act, policymakers and providers need to understand how older veterans are insured, particularly before Medicare eligibility at age 65. Using data from 1996 to 2018, this study examines the insurance patterns of veterans prior to the expansion of access to community care through the VA and compares those patterns to nonveterans. This study finds that veterans are more likely to have insurance than nonveterans and that they are less likely to rely on Medicaid and Medicare before age 65. Regression estimates also suggest that veterans with at least some college education are less likely to have private insurance and are more likely to be uninsured than nonveterans with the same educational attainment. Full article
(This article belongs to the Special Issue Health Economics and Insurance)
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13 pages, 1489 KiB  
Article
The Evolution of Job Lock in the U.S.: Evidence from the Affordable Care Act
by James Bailey, Gregory Colman and Dhaval Dave
J. Risk Financial Manag. 2022, 15(7), 296; https://doi.org/10.3390/jrfm15070296 - 3 Jul 2022
Cited by 3 | Viewed by 4807
Abstract
Since at least the early 1990s, economists have found substantial evidence of “job lock” in the United States: workers who get health insurance from their employer are less likely to switch jobs. Early work showed stronger job lock among groups that place a [...] Read more.
Since at least the early 1990s, economists have found substantial evidence of “job lock” in the United States: workers who get health insurance from their employer are less likely to switch jobs. Early work showed stronger job lock among groups that place a higher value on health insurance, whereas more recent work has focused on measuring the effect of specific policies on job lock. We combine these approaches by replicating some of the classic group comparisons (job switching among the more versus less healthy, and among those whose spouses do or do not have their own health insurance) over a much longer time period, using data from the Current Population Survey and the Medical Expenditure Panel Survey. This enables us to document the evolution of job lock over time, with a particular focus on how it changed when policies such as the Affordable Care Act (ACA) took effect. Estimates based on a difference-in-differences methodology indicate that job lock remains substantial, and that ACA has not significantly affected job mobility. Full article
(This article belongs to the Special Issue Health Economics and Insurance)
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29 pages, 694 KiB  
Article
The Effects of Certificate-of-Need Laws on the Quality of Hospital Medical Services
by Thomas Stratmann
J. Risk Financial Manag. 2022, 15(6), 272; https://doi.org/10.3390/jrfm15060272 - 17 Jun 2022
Cited by 9 | Viewed by 4774
Abstract
Certificate-of-need (CON) laws restrict entry into health services by requiring healthcare providers to seek approval from state healthcare regulators before making any major capital expenditures. An important question is whether CON laws influence the quality of medical services in CON law states. For [...] Read more.
Certificate-of-need (CON) laws restrict entry into health services by requiring healthcare providers to seek approval from state healthcare regulators before making any major capital expenditures. An important question is whether CON laws influence the quality of medical services in CON law states. For instance, if CON laws actually lower the quality of medical services, they fail to achieve their intended effect. This paper tests the hypothesis that hospitals in states with CON laws provide lower-quality services than hospitals in states without CON laws. Our overall results suggest that CON regulations lead to lower-quality care for some quality measures and have little or no effect on other quality standards. The results remain consistent across several robustness tests. Full article
(This article belongs to the Special Issue Health Economics and Insurance)
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11 pages, 484 KiB  
Article
Certificate of Need Laws and Health Care Use during the COVID-19 Pandemic
by Agnitra Roy Choudhury, Sriparna Ghosh and Alicia Plemmons
J. Risk Financial Manag. 2022, 15(2), 76; https://doi.org/10.3390/jrfm15020076 - 13 Feb 2022
Cited by 8 | Viewed by 4516
Abstract
This paper investigates the impact of state-level Certificate-of-Need (CON) laws on COVID and non-COVID deaths in the United States during the SARS-CoV-2 pandemic. CON laws limit the expansion and acquisition of new medical services, such as new hospital beds. The coronavirus pandemic created [...] Read more.
This paper investigates the impact of state-level Certificate-of-Need (CON) laws on COVID and non-COVID deaths in the United States during the SARS-CoV-2 pandemic. CON laws limit the expansion and acquisition of new medical services, such as new hospital beds. The coronavirus pandemic created a surge in demand for medical services, which might be exacerbated in some states that have CON laws. Our investigation focuses on mortality due to COVID and non-COVID reasons and understanding how these laws affect access to healthcare for illnesses that might require similar medical equipment to COVID patients. We find that states with high healthcare use due to COVID that reformed their CON laws during the pandemic had a reduction in mortality resulting from COVID-19, septicemia, diabetes, chronic lower respiratory disease, influenza or pneumonia, and Alzheimer’s Disease, relative to non-reforming CON states. Full article
(This article belongs to the Special Issue Health Economics and Insurance)
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18 pages, 1538 KiB  
Article
The Economics of a Bed Shortage: Certificate-of-Need Regulation and Hospital Bed Utilization during the COVID-19 Pandemic
by Matthew Mitchell and Thomas Stratmann
J. Risk Financial Manag. 2022, 15(1), 10; https://doi.org/10.3390/jrfm15010010 - 31 Dec 2021
Cited by 10 | Viewed by 5667
Abstract
Certificate-of-need (CON) laws are intended to restrain health care spending by limiting the acquisition of duplicative capital and the initiation of unnecessary services. Critics contend that need is difficult to objectively assess, especially considering the risks and uncertainty inherent in health care. We [...] Read more.
Certificate-of-need (CON) laws are intended to restrain health care spending by limiting the acquisition of duplicative capital and the initiation of unnecessary services. Critics contend that need is difficult to objectively assess, especially considering the risks and uncertainty inherent in health care. We compare statewide bed utilization rates and hospital-level bed utilization rates in bed CON and non-bed CON states during the COVID-19 pandemic. Controlling for other possibly confounding factors, we find that states with bed CONs had 12 percent higher bed utilization rates and 58 percent more days in which more than 70 percent of their beds were used. Individual hospitals in bed CON states were 27 percent more likely to utilize all of their beds. States that relaxed CON requirements to make it easier for hospitals to meet the surge in demand did not experience any statistically significant decreases in bed utilization or number of days above 70 percent of capacity. Nor were hospitals in states that relaxed their CON requirements any less likely to use all their beds. Certificate-of-need laws seem to have exacerbated the risk of running out of beds during the COVID-19 pandemic. State efforts to relax these rules had little immediate effect on reducing this risk. Full article
(This article belongs to the Special Issue Health Economics and Insurance)
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