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- All Subjects: Non-market valuation
- Creators: Ketcham, Jonathan
Description
The Patient Protection and Affordable Care Act of 2010 was created as an overhaul of the US Healthcare system with a goal of getting all American citizens and legal residents healthcare that was both affordable and of good quality. Now almost a year removed from it going into effect, this study looks to determine how the ACA has worked in getting individuals who were previously uninsured and required charitable-based healthcare into health insurance programs within a small population in Arizona. This study evaluates the type of insurance program, the quality and ease of access of the care, and the general affordability of the healthcare. This study found that 75% of individuals surveyed had gained health insurance in the last year, with 95% expecting to be insured for 2015. The large majority rated the quality of their care and the accessibility of it as good, with corresponding increased use of primary care providers as a health resource. The affordability of the care was still a major issue for those who were found to be uninsured and for those who were insured. Despite affordability issues, self-reported measures of general health and access to care were reported by the majority of respondents to have improved over the last 12 months.
ContributorsHonan, Timothy Francis (Author) / Ketcham, Jonathan (Thesis director) / Jehn, Megan (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor)
Created2015-05
Description
My dissertation combines the notion of residential sorting from Tiebout (1956) with Grossman’s (1972) concept of a health production function to develop a new empirical framework for investigating what individuals’ residential location choices reveal about their valuation of amenities, the welfare effects of climate change, the forces underlying environmental justice, and the value of a statistical life. Location
choices are affected by age, health, and financial constraints, and by exposure to local amenities that affect people’s health and longevity. Chapter 1 previews how I formalize this idea and investigate its empirical implications in three interrelated essays. Chapter 2 investigates interactions between health, the environment, and income. Seniors tend to move at higher rates after being diagnosed with new chronic medical conditions. While seniors generally tend to move to locations with less polluted air, those who have been diagnosed with respiratory conditions move to relatively more polluted locations. This counterintuitive pattern is reconciled by documenting that new diagnoses bring about increases in medical expenditures, thereby limiting disposable income that can be spent on housing. Relatively cheaper places tend to be more polluted, and higher exposure to pollution leaves seniors more vulnerable to future health shocks. In Chapter 3, I combine information about housing prices with estimates of location-specific effects on mortality to estimate the Value of a Statistical Life (VSL) for seniors - one of the most important statistics used to evaluate policies affecting mortality. Since local amenities correlate with causal mortality effects, but also provide utility independently, the difficulty in controlling for local amenities implies that my VSL estimates are best interpreted as bounds. Chapter 4 builds a new structural framework for evaluating spatially heterogeneous changes to local amenities. I estimate a dynamic model of location choice with a sample of 5.5 million seniors from 2001-2013. Their average annual willingness-to-pay to avoid future climate change in the United States under a “business as usual” scenario ranges from $962 for older, sicker groups who are more vulnerable to climate change’s negative effects on health to -$1,894 for younger, healthier groups, who value warmer winters and are relatively resilient.
choices are affected by age, health, and financial constraints, and by exposure to local amenities that affect people’s health and longevity. Chapter 1 previews how I formalize this idea and investigate its empirical implications in three interrelated essays. Chapter 2 investigates interactions between health, the environment, and income. Seniors tend to move at higher rates after being diagnosed with new chronic medical conditions. While seniors generally tend to move to locations with less polluted air, those who have been diagnosed with respiratory conditions move to relatively more polluted locations. This counterintuitive pattern is reconciled by documenting that new diagnoses bring about increases in medical expenditures, thereby limiting disposable income that can be spent on housing. Relatively cheaper places tend to be more polluted, and higher exposure to pollution leaves seniors more vulnerable to future health shocks. In Chapter 3, I combine information about housing prices with estimates of location-specific effects on mortality to estimate the Value of a Statistical Life (VSL) for seniors - one of the most important statistics used to evaluate policies affecting mortality. Since local amenities correlate with causal mortality effects, but also provide utility independently, the difficulty in controlling for local amenities implies that my VSL estimates are best interpreted as bounds. Chapter 4 builds a new structural framework for evaluating spatially heterogeneous changes to local amenities. I estimate a dynamic model of location choice with a sample of 5.5 million seniors from 2001-2013. Their average annual willingness-to-pay to avoid future climate change in the United States under a “business as usual” scenario ranges from $962 for older, sicker groups who are more vulnerable to climate change’s negative effects on health to -$1,894 for younger, healthier groups, who value warmer winters and are relatively resilient.
ContributorsMathes, Sophie (Author) / Kuminoff, Nicolai V. (Thesis advisor) / Murphy, Alvin D (Thesis advisor) / Bishop, Kelly C. (Committee member) / Ketcham, Jonathan (Committee member) / Bick, Alexander (Committee member) / Arizona State University (Publisher)
Created2020