dc.description.abstract | This doctoral dissertation studies competition in health care markets and the labor market
consequences of health behavior. The focus is on examining how the special characteristics
of health care markets and the provider incentives affect the market structure,
health care qualities, prices, and social welfare. The dissertation consists of an introductory
chapter and four separate essays. The introductory chapter discusses the special
features of health care markets, research questions, and methods and data used and provides
an overview of the main results and policy implications. The first three essays are
theoretical contributions and the fourth is empirical.
The first essay studies price and quality competition in markets with public and
private providers. We show that equilibrium qualities are often inefficient, but under
some conditions on the consumer valuation distribution, equilibrium qualities coincide
with the first best.
The second essay extends the analysis to consider qualities with multiple attributes.
I show that additional assumptions on the per-unit production cost of quality are required
for the equilibrium qualities to be efficient. The results of the first two essays
reveal which properties on the consumer preference distribution and the per-unit production
costs have been driving the results in the previous literature.
The third essay studies how regulation of health care payment schemes and licensing
affect health care providers’ entry and health care quality decisions when some patients
have inaccurate quality perceptions. I show that entry licensing combined with a
regulated prospective payment scheme may be preferable to an unregulated entry and a
more complicated provider reimbursement scheme. Providing better information about
provider quality may also have different direct and indirect effects depending on whether
patients underreact or overreact to health care quality.
The fourth essay analyzes linkages between the different durations of being overweight
and long-term labor market outcomes. We find that being persistently overweight
in early adulthood drives lower subsequent long-term earnings for women and men. The
potential mechanism seems to be different for women and men. For women, the earnings
penalty is related to their weaker labor market attachment. For men, the earnings penalty
is not related to their labor market attachment and instead is related to something that
erodes their earnings power on the labor market throughout their life cycle.
Keywords: Competition, prices, quality, public and private firms, multi-dimensional
product differentiation, regulation, entry, mixed payment schemes, overweight,
obesity, long-term labor market outcomes, labor market attachment. | en |