Essays in Health Economics: Empirical Studies on Employment-Based Health Insurance Plans and Hospice Care

Iwona Kicinger

Advisor: Robin Hanson

Committee Members: Walter E. Williams, Thomas Stratmann, Jack L. Hadley

Carow Hall, Conference Room
December 07, 2009, 07:00 PM to 07:00 PM

Abstract:

This dissertation describes results of empirical studies addressing issues in health economics. The investigated problems include two major topic areas: employment-based health insurance plans and hospice care. In particular, we empirically examine the determinants of the employers' contributions towards health insurance premiums, the price elasticity of demand in employer-provided self-insured health plans, and the effects of hospice ownership and certification on the length of hospice. 

We extend previous empirical work on employment-based health insurance to self-insured health plans and show that union membership and self-insurance predict higher amounts of employer's contribution to health insurance premiums. Our empirical estimates of the price elasticity of demand for self-insured health plans show it to be relatively inelastic.

We also investigate the effects of ownership form and certification status on hospice care. Overall, we find a positive effect of the for-profit organizations on the length of hospice use. In particular, patients with long expected length of hospice use have lower mortality at for-profit hospices whereas patients with short expected length of hospice use have higher mortality. There is no evidence of systematic selection of long-stay patients by for-profit hospices. Furthermore, the results of the impact of hospice certification show that patients have shorter survival times at certified hospices.