SELECTED FOR YOU... NOVEMBER-DECEMBER 2012:
books of the month
site of the month
working papers

All the Selected for you

BOOKS OF THE MONTH

Social inclusion and social protection in the EU: Interactions between law and policy.
Inclusion sociale et protection sociale dans l'Union européenne : interactions entre législation et politique.

Cantillon B. / éd., Verschuren H. / éd., Ploscar P. / éd.
Cambridge : Intersentia : 2012 : 17 p. + 231 p.

Issues of social inclusion and social protection were brought to the fore of political and academic discussions once again by the Treaty of Lisbon. The fight against social exclusion, the promotion of social justice and protection, as well as social cohesion are confirmed to be among the aims of the Union (Article 3 TEU). Moreover, requirements linked to the guarantee of adequate social protection and the fight against social exclusion should be considered both at the levels of design and implementation of EU policies and activities (Article 9 TFEU). The interaction between legal instruments and policy coordination in the field of social inclusion and social protection constitutes the theme of this book. The contributions essentially inquire whether there is any interaction at all, or if the two realms of law and policy of the EU function in parallel. If there is any sort of interchange between the two, in what areas is it taking place, and what does it result into? Legal and political scholars were invited to address these questions and analyse the involvement of the European Union in promoting social inclusion and protection. The book opens with two introductory chapters on the political and legal contexts, and then focuses on the specific cases of health care, pension systems, and means of combating poverty. Each subject matter has been addressed in a complementary fashion through the lenses of juridical and political sciences, which lends the book a cross-disciplinary approach.

Private Health Insurance in the United Kingdom.
Assurance maladie privée au Royaume-Uni.

Thomson S., Foubister T., Mossialos E., McGuire A.
Copenhague : OMS Bureau régional de l'Europe : 2012 : 19 p.

This study provides a descriptive overview of the market for supplementary voluntary health insurance (VHI), or private medical insurance (PMI), in the United Kingdom. The structure of the study reflects the three principal dimensions of the market: the product (Chapter 2), demand (Chapter 3) and supply (Chapter 4). An appendix discusses the market for health cash plans, an alternative type of private medical expenses cover with a relatively broad take-up. The Introduction provides the background necessary for understanding the nature and role of the market for PMI.

Ageing, health and pensions in Europe: an economic and social policy perspective.
Vieillissement, santé et pensions de retraite ; une perspective de politique sociale et économique.

Bovenberg L. / éd., Van Soest A. / éd., Zaidi A. / éd.
Basingstroke : Palgrave Macmillan : 2010 : 400 p.

This book presents an engaging overview of the future research challenges for economists and social scientists concerning population ageing, pensions, health and social care in Europe. Various experts discuss how scientific research can provide cutting-edge evidence on income security of the elderly, well-being of the elderly, and labour markets and older workers: three themes dominating the current European economic and social policy debate. By adopting a forward-looking approach, the book discusses the remaining knowledge gaps and research opportunities. It also reviews data needs and other infrastructure requirements and explores the implications for research policy.

SITES OF THE MONTH

Henvinet – Health and environment networking portal

www.henvinet.eu

 

OMS – Public health and Environment

www.who.int/phe/en

 

WORKING PAPERS

Health Insurance

Private Health Insurance in the United Kingdom.

Thomson S., Foubister T., Mossialos E., Mcguire A. (2012)
Observatory Studies Series. Copenhague : OMS Bureau régional de l'Europe

This study provides a descriptive overview of the market for supplementary voluntary health insurance (VHI), or private medical insurance (PMI), in the United Kingdom. The structure of the study reflects the three principal dimensions of the market: the product (Chapter 2), demand (Chapter 3) and supply (Chapter 4). An appendix discusses the market for health cash plans, an alternative type of private medical expenses cover with a relatively broad take-up. The Introduction provides the background necessary for understanding the nature and role of the market.

Health Economics

Financing Health Care Expenditure in the OECD Countries: Evidence from a Heterogeneous, Cross-Sectionally
Dependent Panel.

De Mello-Sampayo F., De Sousa-Valle S. (2012)
Munich : MRPA

This paper analyses the relationship between health expenditure and the way it is financed using a panel of 30 OECD countries observed since the 1990s. In particular, the nonstationarity and cointegration properties between health care spending and its sources of funding, income and non-income variables are studied. This is performed in a panel data context controlling for both cross-section dependence and unobserved heterogeneity. The findings suggest that when health care expenditure is mainly financed by government it becomes highly inelastic, with an income elasticity much smaller than expected, controlling for dependency rates for old and young age structure and technological progress.

Essays on health and labor economics.

Hullegie P.G.J. (2012)
Le Tilburg : Center for Economic Research

This thesis consists of three parts. The first part (chapter 2) examines the validity of a method that aims at improving the interpersonal comparability of self-reports in surveys. The second part (chapters 3 and 4) is concerned with the question how the demand for medical care is related to health insurance, and to health, respectively. The third part (chapter 5) studies whether job search requirements help older workers to find a job more quickly.

Out-of-Pocket Health Care Expenditure in Turkey: Analysis of the Household Budget.

Basar D., Brown S., Risa H.A. (2012)
Sheffield : Uniersity of Sheffield

This paper analyses the prevalence of ‘catastrophic' out-of-pocket health expenditure in Turkey and identifies the factors which are associate- d with its risk using the Turkish Household Budget Surveys from 2002 to 2008. A sample selection approach based on Sartori (2003) is adopted to allow for the potential selection problem which may arise if poor households choose not to seek health care due to concerns regarding its affordability. The results suggest that poor households are less likely to seek health care as compared to non-poor households and that a negative relationship between poverty and experiencing catastrophic health expenditure remains even after allowing for such selection bias. Our findings, which may assist policy-makers concerned with health care system reforms, also highlight factors such as insurance coverage, which may protect households from the risk of incurring catastrophic health expenditure.

Social Health Inequalities

Musn't grumble. Immigration, Health and Health Service Use in the UK and Germany.

Wadsworth J. (2012)
Bonn : IZA

A rise in population caused by increased immigration is sometimes accompanied by concerns that the increase in population puts additional or differential pressure on welfare services which might affect the net fiscal contribution of immigrants. The UK and Germany have experienced significant increases in immigration in recent years and this study uses longitudinal data from both countries to examine whether immigrants differ in their use of health services than native born individuals on arrival and over time. While immigrants to Germany, but not the UK, are more likely to self-report poor health than the native-born population, the samples of immigrants use hospital and GP services at broadly the same rate as the native born populations in both countries. Controls for observed and unobserved differences between immigrants and native-born sample populations make little difference to these broad findings.

Drugs

The effects of price regulation of pharmaceutical industry margins: A structural estimation for anti-ulcer drugs in France.

Dubois P., Lasio L. (2012)
Londres : University of York

The objective of this paper is to study the effects of price regulation on competition in the pharmaceutical industry. We provide a method allowing to identify margins in an oligopoly price competition game even when prices may not be freely chosen by firms. We use our identification strategy to study the effects of regulatory constraints on prices in the pharmaceutical industry which is heavily regulated in particular in France. We use data from the US, Germany and France to identify country specific demand models and then recover price cost margins under the regulated price setting constraints on the French market. To do so, we estimate a structural model on the market for anti-ulcer drugs in France that allows us to explore the drivers of demand, to identify whether regulation really affects margins and prices and to relate regulatory reforms to industry pricing equilibrium. We provide the first structural estimation of price-cost margins on a regulated market with price constraints and show how to identify unknown possibly binding constraints thanks to three different markets (US, German and France) with varying regulatory constraints. The identified margins show that margins have increased over time in France but that firms were specially constrained in price setting after 2004.

Primary Health Care

An Analysis of the Effects of Health Insurer Monopsony Power on Primary Care Physician Practices.

Brunt C.S., Bowblis J.R. (2012)
Rochester : Social Science electronic publishing.

Consolidation within the market for health insurance has generated significant concern that insurers are using monopsony power in a manner that is harmful to social welfare. This paper uses physician level survey data to ascertain if the ability of insurers to exercise monopsony power affects physician markets. Specifically, we look at the market for primary care physician services, and evaluate previously made assertion- s that public pay beneficiaries (i.e., Medicare and Medicaid) are not adequate substitutes for private pay patients in response to great private insurer monopsony power. We find no evidence that insurer market concentration changes the volume of physician services, willingness to accept new Medicare beneficiaries, or perceived Medicare reimbursement inadequacy with increased insurer concentration. However, we find significa nt reductions in the percentage of practice revenues originating from private payers, increased levels of acceptance of new Medicaid recipients, and reduced perception of Medicaid payment inadequacy, in response to greater insurer market concentration. We also find that insurer concentration leads physicians to integrate into multi-physician practices and find weak evidence that physicians reduce financial risk by affiliating with hospitals and accepting salaried financial arrangements. These results have implications for the Patient Protection and Affordable Care Act (PPACA) as recent evidence suggests the legislation has and will lead to increased insurer consolidation.

DISMEVAL. Developing and validating disease management evaluation methods for European healthcare systems.

Nolte E., Hinrichs S. (2012)
Santa Monica : Rand corporation

The report documents the overall findings of the work carried out within the DISMEVAL project which was funded under the European Commission's 7th Framework Programme. It sought to review current approaches to chronic care and their evaluations, as implemented by EU Member States at national and regional levels and to explore the policy context for chronic disease management in European countries. Reporting on the range of approaches to chronic care adopted in 13 European countries it emphasises the need for the development of a coherent response to chronic disease that takes account of the various tiers in the system and along the care continuum, with involvement of professionals forming a crucial component for achieving sustainable change. The DISMEVAL project further sought to test and validate different evaluation methods using existing data from disease management interventions in six countries. In doing so, it advances the research base in evaluation design and methodology, so informing the design of future evaluations and enhancing their value for decisionmaking. Work carried out identified and tested a wide range of methods that can be employed in situations where experiment- al approaches are not possible, emphasising that rigorous evaluation is still possible where baseline or predefined control groups are not available and how advanced designs can help better understand how different (combinations of) care components and processes might be effective for managing chronic disease in patients with different characteristics. It argues how future evaluation work drawing on such approaches should provide insight into what works for whom in the area of disease management, a question that randomised trials have thus far been unable to answer.

Work and Health

Well-being and psychological consequences of temporary contracts : the case of younger italian employees.

Carrieri V., Di N.C., Jacobs R., Robone S. (2012)
York : University of York

Working conditions in Western countries have changed dramatically in the last twenty years, witnessing the emergence of new forms of employment contracts. The number of "standard" fulltime permanent jobs has decreased, while non-standard work arrangements such as temporary, contingent or part-time contracts have become much more common. This paper analyses the impact of temporary contracts and job insecurity on well-being among younger Italian employees. We use the "Health Conditions and Use of the Health Service Survey" carried out by the Italian National Institute of Statistics in conjunction with the Bank of Italy's Survey on Households Income and Wealth (SHIW). We consider four dimensions of individual well-being: physical health, mental health, self-assessed health and happiness. To account for individual heterogeneity we match each temporary worker with a permanent worker using propensity score matching. Well-being of matched individuals is compared to estimates of the average effect of working with a temporary as opposed to a permanent contract. Our analysis reveals a negative relationship between psychological well-being, happiness and having a temporary job and is particularly marked for males.

Labour market impacts from disability onset.

Polidano C., Vu A. (2012)
Melbourne : Australian National University

This paper estimates the causal impacts of disability onset on labour market outcomes up to four years after onset using longitudinal data from the Household Income and Labour Dynamics Australia (HILDA) survey and difference-in-difference propensity score matching techniques. It finds lasting negative impacts on full-time employment, which is linked more to people foregoing opportunities to move to full-time work rather than downshifting from full-time to part-time work. Impacts are greater for those without post-school qualifications because they face poor prospects once dislocated from work. These results point to the importance of prevention and vocational rehabilitation programs that are targeted at low-skilled workers.