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- Creators: Brian, Jennifer
Description
This work is driven by two facts. First, the majority of households in the U.S. obtain health insurance through their employer. Second, around 20% of working age households choose not to purchase health insurance. The link between employment and health insurance has potentially large implications for household selection into employment and participation in public health insurance programs. In these two essays, I address the role of public and private provisions of health insurance on household employment and insurance decisions, the distribution of welfare, and the aggregate economy. In the first essay, I quantify the effects of key parts of the 2010 health care reform legislation. I construct a lifecycle incomplete markets model with an endogenous choice of health insurance coverage and calibrate it to U.S. data. I find that the reform decreases the fraction of uninsured households by 94% and increases ex-ante household welfare by 2.3% in consumption equivalence. The main driving force behind the reduction in the uninsured population is the health insurance mandate, although I find no significant welfare loss associated with the elimination of the mandatory health insurance provision. In the second essay, I provide a quantitative analysis of the role of medical expenditure risk in the employment and insurance decisions of households approaching retirement. I construct a dynamic general equilibrium model of the household that allows for self-selection into employment and health insurance coverage. I find that the welfare cost of medical expenditure risk is large at 5% of lifetime consumption equivalence for the non-institutionalized population. In addition, the provision of health insurance through the employer accounts for 20% of hours worked for households ages 60-64. Finally, I provide an quantitative analysis of changes in Medicare minimum eligibility age in a series of policy experiments.
ContributorsJanicki, Hubert Piotr (Author) / Prescott, Edward C. (Thesis advisor) / Rogerson, Richard (Committee member) / Hosseini, Roozbeh (Committee member) / Arizona State University (Publisher)
Created2011
Description
Intestinal Transplant is becoming more prevalent with time as an powerful alternative to other therapies for intestinal failure such as parenteral nutrition. The small intestine is an organ especially susceptible to ischemia, or the lack of blood and oxygen supply to an organ. I studied ischemia at Yale Medical School in the lab of Dr. John Geibel. The purpose of this study was to find which kind of solution best protects the intestine from ischemia as well as which segments of the intestine are more susceptible to ischemic damage. This was done by cold static storage as well as through perfusing the organ with a unit developed in the lab called the Intestinal Perfusion Unit (IPU). Intestines were procured from deceased donors following the protocol for handling human specimen and then flushed with either the University of Wisconsin (UW) solution or the Histidine-tryptophan-ketoglutarate solution (HTK). It was found that the jejunum is more susceptible ischemia than the ileum. It was also found that in the jejunum, when using UW solution there was less damage then when using HTK. Clinically, this means that in transplant, if the ileum part is used, there is less risk for ischemic damage. The potential applications of this research raise many ethical issues related to organ transplantation more broadly. The ethical issues include but are not limited to: consent, distribution and need-based donation, transplant tourism, and cost and access. The costs for transplant are exorbitant for the average American. Private insurance companies and Medicare have no policy for intestinal transplant and are therefore not covering many patients in need. In this thesis, I briefly explore the role of insurance companies in the equitable distribution of innovative medical interventions.
ContributorsAgarwal, Raghav (Author) / Brian, Jennifer (Thesis director) / Finotti, Michele (Committee member) / W.P. Carey School of Business (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05