health expenditure growth looking beyond the average through decomposition of the full distribution explanations of growth in health expenditures have restricted attention to the mean we explain change throughout the distribution of expenditures providing insight into how expenditure growth and its explanation differ along the distribution we analyse dutch data on actual health expenditures linked to hospital discharge and mortality registers full distribution decomposition delivers findings that would be overlooked by examination of changes in the mean alone the growth rate of hospital expenditures is greatest at the middle of the distribution and is driven mainly by changes in the distributions of determinants pharmaceutical expenditures increase most rapidly at the top of the distribution and are mainly attributable to structural changes including technological progress making treatment of the highest cost cases even more expensive changes in hospital practice styles make the largest contribution of all determinants to increased spending not only on hospital care but also on pharmaceuticals suggesting important spill over effects

a cluster analysis on income elasticity variations and us pharmaceutical expenditures this paper examines the relationship between household income and outpatient prescribed medicines in the usa based on a sample of 2872 privately insured patients from the 1987 nmes data set the analysis is performed on regional typologies of different socioeconomic profiles of patients only a few groups show positive income elasticity

what drives health care expenditure baumol s model of unbalanced growth revisited the share of health care expenditure in gdp rises rapidly in virtually all oecd countries causing increasing concern among politicians and the general public yet economists have to date failed to reach an agreement on what the main determinants of this development are this paper revisits baumol s baumol w j 1967 macroeconomics of unbalanced growth the anatomy of urban crisis american economic review 57 3 415 426 model of unbalanced growth showing that the latter offers a ready explanation for the observed inexorable rise in health care expenditure the main implication of baumol s model in this context is that health care expenditure is driven by wage increases in excess of productivity growth this hypothesis is tested empirically using data from a panel of 19 oecd countries our tests yield robust evidence in favor of baumol s theory

do cigarette producers price discriminate by state an empirical analysis of local cigarette pricing and taxation abstract this study analyzes the interactive effects of oligopoly pricing state taxation and anti smoking regulations on retail cigarette prices by state using panel data for the 50 us states between 1960 and 1990 the results indicate that cigarette producers do price discriminate by state though the effect is not large relative to the final retail price there are two further results 1 state taxes are more than passed on a 1 cent state tax increase results in a price increase of 1 11 cents and 2 sellers offset state and local anti smoking laws with lower prices thereby blunting effects of the regulations

is health care a necessity or a luxury pooled estimates of income elasticity from us state level data this paper provides new evidence on the income elasticity of health care by combining stationarity and cointegration tests of health care expenditure and incomes with estimates of the cointegrating relationship between them a recently updated dataset of health care expenditures and disposable personal income for the us states for the years 1966 1998 is used the principal findings are that health care expenditures and incomes at the state level are non stationary and cointegrated dynamic ols cointegrating regressions of the pooled state time series estimate the income elasticity of health care at 0 817 to 0 844 well below unity confirming that health care expenditure even at the aggregate level is a necessity good

estimating dynamic demand for cigarettes using panel data the effects of bootlegging taxation and advertising reconsidered abstracct a dynamic demand for cigarette consumption is estimated using pooled data of 46 states over the period 1963 to 1980 a price elasticity of 0 2 and an insignificant income elasticity is found using pooled estimation techniques the bootlegging effect is modeled explicitly using neighboring price the effect is found to be significant two major policy issues are analyzed in light of these new estimates 1 cigarette taxation is found to be an effective tool for generating revenues even though there may be spillover effects to neighboring states where bootlegging is significant 2 the effects of the fairness doctrine act and the advertising ban on cigarette consumption are re examined we find mild support for the effectiveness of subsidized anti smoking messages in reducing cigarette consumption and no support for the thesis that the ban on advertising helps to increase per capita consumption

interrelationships between income health and the environment extending the environmental kuznets curve hypothesis abstract this paper examines the link between the health indicators and the environmental variables for a cross section of countries widely dispersed on the economic development spectrum while environment and income are seen to have an inverted u shaped relationship environmental kuznets curve ekc hypothesis it is also well established that environment and health are positively related our study focuses on the implications of this for the relationship between health and income in the early phases of income growth the gains in health and the losses in environmental quality could cancel each other out and this challenges the idea that as incomes increase health would always improve to empirically analyse these issues we estimate a two stage least squares model that focuses on the impact of income and the environment on health status with environment being an endogenous variable our results show that the environmental stress variable has a significant negative effect on health status at the same time gross national product gnp levels are shown to vary positively with health status variables we find that the health gains obtained through improved incomes can be negated to a significant extent if the indirect effect of income acting via the environment is ignored research findings in this regard would be a useful policy instrument towards maximising both the environmental and health gains that come with economic growth and development

equity in the finance of health care some international comparisons this paper presents the results of a ten country comparative study of health care financing systems and their progressivity characteristics it distinguishes between the tax financed systems of denmark portugal and the u k the social insurance systems of france the netherlands and spain and the predominantly private systems of switzerland and the u s it concludes that tax financed systems tend to be proportional or mildly progressive that social insurance systems are regressive and that private systems are even more regressive out of pocket payments are in most countries an especially regressive means of raising health care revenues

can baumol s model of unbalanced growth contribute to explaining the secular rise in health care expenditure an alternative test in a recent paper i argued that baumol s model of unbalanced growth offers a ready explanation for the observed secular rise in health care expenditure hce in rich countries baumol s model implies that hce is driven by wage increases in excess of productivity growth i tested this hypothesis empirically using data from a panel of 19 organization for economic cooperation and development oecd countries and found robust evidence in favour of baumol s theory an alternative way to test baumol s theory is to check whether its implication that variations in the relative price of medical care contribute significantly to explaining variations in health expenditure in the same direction has an empirical grounding earlier studies although mostly not in an explicit attempt to test baumol s theory have occasionally rejected this hypothesis despite poor data quality of the available medical price indices i perform the alternative test using data for nine oecd countries my findings suggest that the relat

the growth of public health expenditures in oecd countries do government ideology and electoral motives matter this paper empirically evaluates whether government ideology and electoral motives influenced the growth of public health expenditures in 18 oecd countries over the 1971 2004 period the results suggest that incumbents behaved opportunistically and increased the growth of public health expenditures in election years government ideology did not have an influence these findings indicate 1 the importance of public health in policy debates before elections and 2 the political pressure towards re organizing public health policy platforms especially in times of demographic change

social security income and health care spending evidence from the social security notch the paper exploits social security legislation changes to identify the causal effect of social security income on out of pocket medical expenditures of the elderly using the 1986 1994 consumer expenditure survey and an instrumental variables strategy the empirical results show that health care expenditures are responsive to changes in social security income for elderly individuals with less than a high school education the estimated income elasticities are between 1 41 and 3 47 depending on the outcome measures and are statistically significant at conventional levels the findings are in contrast to existing studies that find a small income elasticity at the individual household level this article is protected by copyright all rights reserved

does morbidity matter perceived health status in explaining the share of healthcare expenditures we argue that the demand for healthcare services can be better explained by individual need based variables rather than by macro variables such as the gross domestic product gdp per capita and the share of public healthcare expenditures this study introduces a self rated health variable called morbidity that describes individual needs for health care healthy individuals need less health care than sick ones and that is measured through personal interviews conducted by the organization for economic co operation and development oecd in addition stationary properties of the series are considered in order to understand the effect of shocks to expenditure behaviour on health care stationary test results show that we should not only use differenced values for the model variables but also incorporate time specific effects into the model using the appropriate specification and accounting for the time effect we find evidence supporting the hypothesis that the share of healthcare expenditure in gdp ris

the determinants of canadian provincial health expenditures evidence from a dynamic panel this article seeks to reveal the magnitude of the income elasticity of health expenditure and the impact of non income determinants of health expenditure across canada for this purpose panel data on gross domestic product the relative price of health care the share of publicly funded health expenditure the share of senior population and the life expectancy at birth have been used to investigate the determinants of canadian provincial health expenditures over a 28 year period dynamic models of health expenditure are analysed via generalized instrumental variables giv and generalized method of moments gmm results indicate that the long run income elasticity of health expenditure is substantially lower than one thus health care is far from being a luxury in canada

demand for medical care consumption and cointegration abstract this paper considers a generalized version of grossman s health capital model and derives a cointegration restriction the restriction is tested using aggregate us data and the results are consistent with the prediction of the model

price and quantity in international comparisons of health care expenditure an important omission from earlier cross national comparisons of health care expenditure has been the failure to distinguish between price and quantity using recent data on purchasing power parities the purpose of this article is to report some preliminary results regarding health care expenditure and quantity across 22 oecd countries the article concludes that contrary to what has been suggested in some recent articles the relative price of health care is not correlated to the aggregate per capita income the fraction of the national income that is devoted to health care provision increases with the per capita income regardless of whether health care is measured in terms of expenditure or quantity the relative price of health care has a rationing effect on the quantity of health care that is offered with a price alasticity close to minus one the latter finding means that the health care expenditure is not greater in countries with higherprices furthermore the differences in health care expendit

determinants of health care expenditure in africa a cross sectional study the paper presents some quantitative evidence on the relationship between certain socioeconomic and demographic factors and per capita health care expenditure in africa first gnp per capita percentage of births attended by health staff and foreign aid received per capita together explained 78 3 of the variance in health care expenditure second per capita gnp is the most significant factor explaining differences in health care expenditure contrary to what has been found in comparisons of health care expenditure in the organization for economic cooperation and development oecd countries we found that the income elasticity is close to unity furthermore aid was consistently significant and positive in the three models estimated third variables such as crude birth rate and the population under 15 years of age as percentage of total population were not significant

health care expenditure and integration in the countries of the european union national health care differs between the member states of the european union in the quality and quantity demanded and supplied reflecting different economic structures and health care organization and delivery systems since health care expenditure depends primarily on the level of economic development and the structure of the population only convergence in economic performance and the standards of living can lead to convergence of health expenditure standards

aggregate health care expenditure in the united states evidence from cointegration tests unlike recent studies that are based on international cross sectional series this paper attempts to quantify the role of the determinants of aggregate health care expenditure per capita using time series data for the period of 1960 87 for the united states the paper applies the relatively new procedures of unit root testing cointegration and error correction modelling the evidence supports cointegration although the results indicate that per capita income age of the population number of practising physicians and public financing of health care are important determinants the age structure of the population and number of practising physicians emerge as the major determinants of aggregate health care expenditure in the united states

a theory of rational addiction we develop a theory of rational addiction in which rationality means a consistent plan to maximize utility over time strong addiction to a good requires a big effect of past consumption of the good on current consumption such powerful complementarities cause some steady states to be unstable they are an important part of our analysis because even small deviations from the consumption at an unstable steady state can lead to large cumulative rises over time in addictive consumption or to rapid falls in consumption to abstention our theory also implies that cold turkey is used to end strong addictions that addicts often go on binges that addicts respond more to permanent than to temporary changes in prices of addictive goods and that anxiety and tensions can precipitate an addiction

aggregate health care expenditures and national income is health care a luxury good it is well known that a strong relationship exists between national expenditures on health care and national income this has been used to suggest that health care is a luxury good and that factors such as the type of health care delivery system in a country are of little importance in determining expenditure levels this paper argues that these implications rely upon the application of microeconomic analysis to macroeconomic data and that this is not appropriate as well as raising questions about the inferences drawn from previous studies new empirical evidence is presented which casts some doubts on previous findings international comparisons are based on purchasing power parity rather than exchange rate conversions underlining the importance of prices as well as quantities in the relationship and leading to the conclusion that the aggregate data show health care to be if anything a necessity rather than a luxury good

medical care costs how much welfare loss hardly a week goes by without a front page newspaper article on rising health care costs and the uninsured in this article i focus mainly on costs arguing that the issue has been somewhat misconceived while the level of medical care spending in the u s is a cause for concern the welfare losses associated with rises in that level of spending may not be as large as the public rhetoric can make them seem in fact cost containment may not be as urgent as is widely supposed and some proposed cost containment policies may result in welfare losses for the insured and even increase the number of uninsured

tobacco taxes and starting and quitting smoking does the effect differ by education this article uses duration analysis to investigate the role of tobacco taxes in starting and quitting smoking applying a variety of parametric duration models to a sample of irish women it finds that in general tobacco taxes do influence starting and quitting smoking in the expected direction it also finds that the effect for starting differs by education but in a nonmonotonic way with the greatest effect for women with intermediate levels of education the results for quitting suggest the greatest effect for women with the lowest level of education these results are unchanged when account is taken of unobserved heterogeneity

health insurance and the demand for medical care evidence from a randomized experiment we estimate how cost sharing the portion of the bill the patient pays affects the demand for medical services the data come from a randomized experiment a catastrophic insurance plan reduces expenditures 31 percent relative to zero out of pocket price the price elasticity is approximately 0 2 we reject the hypothesis that less favorable coverage of outpatient services increases total expenditure for example by deterring preventive care or inducing hospitalization

public private mix of health expenditure a political economy and quantitative analysis this paper constructs a simple model to examine decisions on public and private health spending under majority voting in the model agents with heterogeneous incomes choose how much to consume and spend on health care and vote for public health expenditure the health status of an agent is determined by a ces composite of public and private health expenditure the existence and uniqueness of the voting equilibrium are established a quantitative exercise reveals the importance of the relative effectiveness of public and private health expenditure and their substitutability in determining the public private mix of health expenditure and in accounting for the observed differences across a sample of 22 advanced democratic countries

review of the literature on the determinants of healthcare expenditure this study reviews the literature on determinants of healthcare expenditure for the period 1998 to 2007 the methodology combines searches in the mesh database of pubmed with the search in the principal journals of health economics 20 primary studies were found that met the criteria for inclusion no single pattern of results is clearly identified among the 20 articles four consider income to be the principal determinant of healthcare expenditure two of them jointly with population ageing six highlight population ageing as against six others that emphasize the proximity to death the remaining six do not focus on a specific variable or focus on another variable e g technological progress or territorial decentralization 11 of the 20 articles calculate the income elasticity of demand only two of them obtaining a value greater than 1 thus cataloguing healthcare expenditure as a luxury good there is therefore no unanimity in the variables and econometric regressions of healthcare expenditure in

demand for health a generalised grossman model the demand for health and medical care is analysed within a generalised grossman type health investment model its underlying assumptions are shown to differ from those employed earlier in a manner which avoids some of the criticisms levelled at grossman s model the comparative static predictions of the generalised model are examined and it is demonstrated that most previous health investment models are derivable from it also the present model is applicable to a new wider range of problems thus increasing the scope of economic explanations of health behaviour

does environmental quality influence health expenditures empirical evidence from a panel of selected oecd countries in this paper we examine the role of environmental quality in determining per capita health expenditures we take a panel cointegration approach in order to explore the possibility of estimating both short run and long run impacts of environmental quality our empirical analysis is based on eight oecd countries namely austria denmark iceland ireland norway spain switzerland and the uk for the period 1980 1999 we find that per capita health expenditure per capita income carbon monoxide emissions sulphur oxide emissions and nitrogen oxide emissions are panel cointegrated while short run elasticities reveal that income and carbon monoxide emissions exert a statistically significant positive effect on health expenditures in the long run in addition to income and carbon monoxide we find that sulphur oxide emissions have a statistically significant positive impact on health expenditures

is social protection a necessity or a luxury good new multivariate cointegration panel data results the aim of this paper is to test the claim that social protection is a luxury good therefore gdp elasticity of selected social protection expenditure is estimated using a new econometric approach developed first by kao and chiang advances in econometrics 15 179 222 2000 time series properties of selected social expenditure in 18 oecd countries from 1981 to 1998 are examined using panel data cointegration tests and ols fmols and dols estimators results were found which differ from previous analyses reporting substantially higher income elasticities with the fmols selected social expenditure has income elasticities smaller than one but greater than one with the dols it is noteworthy that whether selected social expenditure is stationary or nonstationary may have critical implications for researchers and policy makers desiring to model and explain the impact of this expenditure on a country economic system

a nearly global look at the dynamics of youth smoking initiation and cessation the role of cigarette prices this study investigates the role of cigarette prices on smoking initiation and cessation among youth in a sample of eight primarily non western low middle and high income countries with a particular focus on a subsample of 40 low and middle income countries lmics using split population duration models on longitudinally transformed individual data from the global youth tobacco survey gyts the average impact of cigarette prices in the presence of unobserved country heterogeneity and shifting cultural norms within countries is identified by the variation of cigarette prices within countries over time price increases are found to effectively reduce initiation in early youth and girls are considerably more responsive than boys the price elasticity of initiation in lmics is 0 82 for the combined gender analysis 0 46 for boys only and 1 5 for girls only there is some indication that youths in developing countries may be slightly less responsive to price changes than in high income countries no

disentangling the heterogeneous income elasticity and dynamics of health expenditure in this article we empirically study the impact of per capita income on health care expenditure and its dynamics over time in a sample of 14 oecd countries for the period 1971 to 2009 a simple model built upon one developed by newhouse 1977 suggests that health care is a necessity in the short run but it cannot be rejected to be a luxury good in the long run our findings provide strong empirical evidence that a year s health expenditure is conditioned by the previous one interestingly our results reveal increasing income inelasticity over time along with huge heterogeneity across countries finally this article supports the hypothesis of conditional convergence in health care spending among countries in designing policies which facilitate the sustainability of national health systems we emphasize that ceteris paribus the greater the participation of public health the lower the growth rate of health spending high share of children and elderly over working age population opposite influences w

household production of health investment analysis and applications michael grossman s health investment model provides significant insights into allocations between both leisure and income and health and nonhealth goods our geometric extension i integrates labor leisure choice with the consumer s production of both health and nonhealth goods and ii distinguishes between medical expenditures and healthcare investment this provides a framework for examining the effects of changes in incomes and wages alternative insurance arrangements including managed care travel times waiting times and schooling observed differences between the income elasticities for health goods and health investment can be resolved through relative resource intensities in the production of health and nonhealth goods

health spending and public pension evidence from panel data abstractthis article empirically investigates the determinants of aggregate health expenditure in a panel of oecd countries from 1980 to 2005 we differ from most existing studies by testing some new determinants motivated by recent theoretical advances in the literature we find that a one percentage increase in public pension payments per elderly person leads to approximately a one third percentage increase in aggregate health spending and this effect is significant and robust across a variety of model specifications a back of the envelope calculation based on this estimate suggests that the expansion of the public pension programme on average accounts for approximately over one fifth of the rise in aggregate health expenditure as a share of gdp in the set of oecd countries during 1980 2005 in addition we find that the estimated effect of gdp per capita in our model ranges from 0 66 to 0 80 which is consistent with the results from some recent studies and thus further reinforces the finding in the

new panel results on cointegration of international health expenditure and gdp this article tests for existence of cointegration between health expenditure and gdp using data from 25 oecd countries for the period 19607ndash 1997 the empirical modelling is based on a heterogeneous bivariate vector error correction panel model that allows for trending data as well as intercepts and trends in the cointegrating relations univariate country by country and panel unit root tests generally fail to reject the null of a unit root in the health expenditure and gdp variables country by country results based on the johansen multivariate likelihood based inference indicate somewhat mixed results on country specific cointegration with a rank of one found for 12 countries and a rank of zero for the remaining 13 countries application of a new panel test for cointegration rank with higher power than the individual tests indicates that health expenditure and gdp are cointegrated around linear trends

evidence on the determinants of canadian provincial government health expenditures 1965 1991 abstract real per capita provincial government expenditures on health care over the period 1965 1991 are examined using pooled time series cross section regression analysis key determinants of real per capita provincial government expenditures on health care over the period 1965 1991 are real provincial per capita income the proportion of the provincial population over age 65 and real provincial per capita federal transfer revenues established program financing had a negative and significant impact on real per capita provincial government health expenditures in newfoundland and quebec an income elasticity of 0 77 implies that health care is not a luxury good

conversion factor instability in international comparisons of health care expenditure parkin mcguire and yule 1987 hereafter pmy report that a regression of per capita health care expenditure on per capita income using different conversion factors exchange rates gdp ppps health ppps gave rise to different results in this note we apply updated data to the same empirical relationship in contrast to pmy we find no noticeable conversion factor instability in that relationship either with respect to the health care income elasticity or with the magnitude of multiple correlation coefficient

equity efficiency and financial risk of alternative arrangements for funding long term care systems in an ageing society partly a reflection of the increasing volume and hence political influence of the older population recent reforms of long term care ltc systems across developed countries have sought to expand the coverage of the services provided and have defined increasingly universal levels of state support for people with social care needs at the same time some of the factors leading to the expansion of the objectives and ambitions of the care system such as the ageing of the population pose significant challenges to its long term financial sustainability in this context the paper first reviews the main factors likely to contribute to the growth in ltc demand and expenditure and reflects on the policy priorities associated with state backed funding systems in the area using results from a bespoke dynamic micro simulation model it then illustrates the discussion through a quantitative analysis of the equity and efficiency implications of alternative funding models discussed in the context of the ongoing reforms of the ltc system in england

is health care a luxury the debate revisited with new evidence from emerging economies abstractthis paper studies the long run relationship between health care expenditure and income using a panel data set of emerging economies over the period 1995 2012 the results show that expenditure on health care and income are non stationary and cointegrated after controlling for cross sectional dependence and unobserved heterogeneity among different countries we find that the income elasticity of health care is less than 1 indicating that health care is a necessity and not a luxury government expenditure and out of pocket expenditure turn out to be important determinants of health care expenditure among non monetary factors results show that old age dependency and female education seem to have significant bearings on health care expenditures policy recommendations suggest that government should increase spending on health care in emerging economies since higher incomes may not automatically translate into higher health care spending by the people of these countries

an econometric analysis of health care expenditure a cross section study of the oecd countries this paper is an empirical examination of the determinants of aggregate health care expenditure the paper presents a systematic analysis of relationships across 19 oecd countries showing the effects of aggregate income institutional and socio demographic factors on health care expenditure the results indicate that institutional factors of the health systems in addition to per capita gross domestic product gdp contribute significantly to the explanation of the health care expenditure variation between countries for example the way physicians in outpatient care are paid and the mixture of public private funding and inpatient outpatient care

on the determination of the us aggregate health care expenditure per capita real health care expenditure is examined against three major groups of explanatory variables economic demographic and health stock and it is found that the three groups of variables have an impact on real health care spending other subcategories such as real private and government health care pharmaceutical dental home nursing ambulatory personal medical consumption and in patient expenditures have also been examined and have been found to be affected by the explanatory variables for several subcomponents there is evidence of supplier inducement of the demographic group of variables the ageing population had an impact only on the per capita real overall and private health care outlay and pharmaceutical spending also cointegrating relationships were found and consistent estimators of the elasticities found

the duration of the smoking habit i introduction most smokers smoke out of habit once the habit is ended many of smoking s most harmful effects decline rather quickly preventing and ending cigarette addiction is therefore the straightest path toward preventing the health damage done by cigarette smoking consequently the related questions of why people start smoking and why they quit are central to formulating and evaluating effective antismoking policies duration or hazard models are designed to measure the probability of transition between states and are thus ideal for investigating the structural determinants of the transition between addiction and non addiction nevertheless most previous work in the economics literature uses the aggregate smoking participation rate defined as the percentage of people who currently smoke or an individual s probability of participation rather than a hazard rate to measure the attractiveness of habitual smoking this paper models the hazard rates of both starting and quitting the cigarette smoking habit the starting hazard rate is the probability that an individual will start smoking in a given time period conditional on being a nonsmoker until then the quitting hazard rate is the probability of quitting smoking in a given time period conditional on being a smoker since the starting date both of these rates should rise and fall in response to changes in the attractiveness of smoking the two rates will respond differently to different stimuli since the starting hazard reflects the point of view of nonsmokers and the quitting hazard reflects the point of view of smokers hazard or duration models possess several advantages over smoking participation models most obviously smoking participation rates cannot directly distinguish between increased starting rates and decreased quitting rates but the hazard models can also in a participation rate model it is difficult to control for the effect of the duration of the habit whereas duration models are designed specifically to allow for and measure the dependence of the hazard rate on duration another advantage is that the participation rate at any one time will oversample the number of long term smokers relative to those who had a short term habit whereas a duration model is designed to avoid this source of bias one drawback however is that because of their inherent panel nature the data requirements of duration models are somewhat more difficult to satisfy as shall be seen the only previous work in the economics literature that estimates the hazard rate of starting smoking is douglas and hariharan 1994 my paper improves upon douglas and hariharan in at least three important ways first it estimates the hazard rate of quitting smoking as well as that of starting second it takes into account variation in state level regulation third its time varying covariate model allows hazard rates to respond dynamically to changes in cigarette price regulation and information variables the use of time varying covariates is important because it brings the empirical model into much closer accord with theory the decision whether or not to start or quit smoking is an ongoing decision made one day at a time on the basis of current information the hazard of starting is greatest when the cost of the habit appears lowest and its benefit appears highest this comparison of cost and benefit changes through time as price information income and life cycle variables change while douglas and hariharan 1994 used price information from the potential smoker s most vulnerable age on the theory that its marginal effect is greatest at that time the model used in this paper allows each individual s hazard rate to respond to changes in price and public information as they occur the leading theoretical model of the decision to smoke is the rational addiction model of becker and murphy 1988 which assumes that consumers of addictive goods begin smoking only after fully weighing the costs and benefits of the habit

public financing of health expenditures insurance and health outcomes the effects of public financing of health expenditures insurance coverage and other factors on health outcomes are examined within health production models estimated using 1960 1992 data across 20 oecd countries mortality rates are found to depend on the mix of health care expenditures and the type of health insurance coverage increases in the publicly financed share of health expenditures are associated with increases in mortality rates increases in inpatient and ambulatory insurance coverage are associated with reduced mortality the effects of gdp health expenditures and age structure on mortality are similar to those in previous studies tobacco use alcohol use fat consumption female labour force participation and education levels are also significantly related to overall mortality rates increases in income inequality are associated with lower mortality rates suggesting that the negative relationship between inequality and health outcomes suggested by some previous studies does not remain w

prices inflation and smoking onset the case of argentina this article examines the effect of tobacco prices on the decision to start smoking in argentina argentina is an interesting case to explore given its high smoking rates its recent experience with periods of very high and hyperinflation and the mixed evidence of the effect of prices on smoking onset particularly in low and middle income countries we used data from four cycles of two large national surveys conducted between 2005 and 2011 and discrete time hazard models we found that tobacco prices had a statistically significant and fairly large impact on the hazard of smoking onset and these findings were robust to alternative specifications we also found that prices had little effect on the hazards of smoking onset during periods of hyper and very high inflation which provide some support for the notion that prices lose their informational role in such periods governments need to be cognizant that their most important policy tool to reduce tobacco use taxes that increase real tobacco prices is likely no longer effective during these times jel c41 h20 i12 i18

the demand for health some new empirical evidence this paper presents some new estimates of the pure investment and pure consumption models of the demand for health in contrast to previous studies the paper presents parameter estimates of both reduced form and structural demand for health care equations the latter which are obtained by treating health capital as a latent variable in a recursive equation system provide a safer way of checking the consistency of the model s predictions with the data the present analysis of the pure consumption model differs from previous analyses in its recognition of the dependency of the shadow price of initial assets on the entire lifetime profiles of the model s exogenous variables the paper also explores the implications in terms of reliability of parameter estimates of the failure on the part of previous studies to recognize this

is health care really a luxury in oecd countries evidence from alternative price deflators this article examines whether real health care expenditure he is a luxury or necessity for organization for economic co operation and development oecd countries over the period 1972 to 2004 within a panel unit root and panel cointegration framework to realize this objective we regress he on real gross domestic product gdp the proportion of the population aged over 65 p65 and a time trend t we first present results for 18 countries where real he per capita is obtained using a general gdp deflator for these countries we find that health care is a luxury for just one country next we present results for eight countries where real he is obtained using a specific health care price index when the general gdp deflator is replaced with a specific health care price index at least one of the gdp p65 or t coefficients for the eight countries changes in a reasonably dramatic fashion suggesting that the use of the gdp deflator introduces bias into the regression we find that he is a necessity in

health care is an individual necessity and a national luxury applying multilevel decision models to the analysis of health care expenditures health care is neither a necessity or a luxury it is both since the income elasticity varies with the level of analysis with insurance individual income elasticities are typically near zero while national health expenditure elasticities are commonly greater than 1 0 the debate over whether health care is or is not a luxury good arises primarily from the failure to specify levels of analysis clearly so as to distinguish variation within groups from variation between groups apparently contradictory empirical results are shown to be consistent with a simple nested multilevel model of health care spending

anatomy of banking crises in developing and emerging market countries abstract this paper uses a binary classification tree bct model to analyze banking crises in 50 emerging market and developing countries during 1990 2005 the bct model identifies three conditions and the specific threshold of the key indictors at which the vulnerability to banking crisis increases i very high inflation ii highly dollarized bank deposits combined with nominal depreciation or low bank liquidity and iii low bank profitability which highlight that foreign currency risk poor financial soundness and macroeconomic instability are important drivers of banking crises the results also emphasize the importance of conditional thresholds in triggering crises in that banking crises are underlined by a combination of vulnerabilities or a sequence of non linear conditions rather than the deterioration of a unique factor