Amy Finkelstein
Datos Biográficos
| ID | 3591740 |
|---|---|
| NOMBRE | Amy Finkelstein |
| NOMBRES | Amy |
| APELLIDO | Finkelstein |
| FIRMA | FINKELSTEIN A |
| AFILIACIONES | National Bureau of Economic Research |
| ORCID | 0000-0002-9941-6684 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAS | 71 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2002 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 6 |
The Effect of Medicaid on Crime
Those involved with the criminal justice system have disproportionately high rates of mental illness and substance-use disorders, prompting speculation that health insurance, by improving treatment of these conditions, could reduce crime. Using the 2008 Oregon Health Insurance Experiment, which randomly made some low-income adults eligible to apply for Medicaid, we find no statistically significant impact of Medicaid coverage on criminal charges …
Heterogeneity in Damages from a Pandemic
We use nationally-representative linked survey and administrative data to document socioeconomic and demographic disparities in the economic and health effects of the COVID-19 pandemic in the United States during its first two years. Impacts on all-cause mortality and on employment were concentrated in the same racial/ethnic, education, industry, and occupation groups. Black-White and Hispanic-White disparities in mortality impacts narrowed over …
A blueprint for U.S. health insurance policy
There is no shortage of proposals for U.S. health insurance reform. In our recent book, We've Got You Covered: Rebooting American Health Care (Einav & Finkelstein, 2023), we offered one more. It grew out of our internal debates over healthcare reform, between two academic economists who work (often together) on U.S. health policy but have not yet been involved in making that policy. We started by trying to define the goal: what is the problem tha…
Response to Jason Furman
We are pleased that Jason Furman responded to our proposal by recommending that the book (on which we base the proposal) should be “required reading by specialists and non-specialists alike” and noting that he “would be perfectly happy if [our] proposal were adopted.” Both comments are extremely gratifying to receive from a skilled and insightful economist, and particularly from someone who was involved—at the highest levels of the Obama Administ…
Targeting Precision Medicine
Previous articleNext article No AccessTargeting Precision Medicine: Evidence from Prenatal ScreeningPeter Conner, Liran Einav, Amy Finkelstein, and Petra PerssonPeter Conner, Liran Einav, Amy Finkelstein, and Petra PerssonPDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookxLinkedInRedditEmailPrint SectionsMoreDetailsFiguresReferencesCited by Journal of Political Economy Just Accepted Article DOIhttps:/…
Long-Term Care Hospitals
There is substantial waste in U.S. healthcare but little consensus on how to combat it. We identify one source of waste: long-term care hospitals (LTCHs). Using the entry of LTCHs into hospital markets in an event study design, we find that most LTCH patients would have counterfactually received care at Skilled Nursing Facilities—facilities that provide medically similar care but are paid significantly less—and that substitution to LTCHs leaves p…
Why Is End-of-Life Spending So High? Evidence from Cancer Patients
We study the sources of high end-of-life spending for cancer patients. Even among patients with similar initial prognoses, spending in the year postdiagnosis is over twice as high for those who die within the year than those who survive. Elevated spending on decedents is predominantly driven by higher inpatient spending, particularly low-intensity admissions. However, most such admissions do not result in death, making it difficult to target spen…
Financial Incentives to Facilities and Clinicians Treating Patients With End-stage Kidney Disease and Use of Home Dialysis
ClinicalTrials.gov Identifier: NCT05005572
Welfare Analysis Meets Causal Inference
We describe a frame work for empirical welfare analysis that uses the causal estimates of a policy's impact on net government spending. This framework provides guidance for which causal effects are (and are not) needed for empirical welfare analysis of public policies. The key ingredient is the construction of each policy's marginal value of public funds (MVPF). The MVPF is the ratio of beneficiaries' willingness to pay for the policy to the net …
Take-Up and Targeting
We develop a framework for welfare analysis of interventions designed to increase take-up of social safety net programs in the presence of potential behavioral biases. We calibrate the key parameters using a randomized field experiment in which 30,000 elderly individuals not enrolled in—but likely eligible for—the Supplemental Nutrition Assistance Program (SNAP) are either provided with information that they are likely eligible, provided with thi…
The Impact of Medicaid Expansion on Voter Participation
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and state administrative data on voter behavior, we analyze how a Medicaid expansion affected voter turnout and registration. We find that Medicaid increased voter turnout in the November 2008 Presidential election by about 7 percent overall, with the effects concentrated in men (18 percent increase)…
The Economic Consequences of Hospital Admissions
We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills, and bankruptcy, and reduce earnings, income, access to credit, and consumer borrowing. The earnings d…
The Value of Medicaid
We develop a set of frameworks for welfare analysis of Medicaid and apply them to the Oregon Health Insurance Experiment, a Medicaid expansion for low-income, uninsured adults that occurred via random assignment. Across different approaches, we estimate recipient willingness to pay for Medicaid between $0.5 and $1.2 per dollar of the resource cost of providing Medicaid; estimates of the expected transfer Medicaid provides to recipients are relati…
Sources of Geographic Variation in Health Care
We study the drivers of geographic variation in U.S. health care utilization, using an empirical strategy that exploits migration of Medicare patients to separate the role of demand and supply factors. Our approach allows us to account for demand differences driven by both observable and unobservable patient characteristics. Within our sample of over-65 Medicare beneficiaries, we find that 40–50% of geographic variation in utilization is attribut…
Moral Hazard in Health Insurance
Using data from employer-provided health insurance and Medicare Part D, we investigate whether healthcare utilization responds to the dynamic incentives created by the nonlinear nature of health insurance contracts. We exploit the fact that, because annual coverage usually resets every January, individuals who join a plan later in the year face the same initial ("spot") price of healthcare but a higher expected end-of-year ("future") price. We fi…
Medicaid Increases Emergency-Department Use
Health Economy? The intensity of arguments over social science issues often seems inversely correlated with the quantity of experimental evidence. Taubman et al. (p. 263 , published online 2 January; see the Policy Forum by Fisman ) report on the latest analysis of an ongoing controlled experiment—the Oregon Health Insurance Experiment—that seeks to identify and quantify the effects of extending health insurance coverage to a low-income adult pop…
The Oregon Experiment — Effects of Medicaid on Clinical Outcomes
BACKGROUND: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. METHODS: Approximately 2 years after the lottery, we obtained data from 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who were not…
Income and Health Spending
Health expenditures as a share of GDP in the United States have more than tripled over the past half-century. A common conjecture is that this is a consequence of rising income. We investigate this hypothesis by instrumenting for local area income with time series variation in oil prices interacted with local oil reserves. This strategy enables us to capture both partial equilibrium and local general equilibrium effects of income on health expend…
The Rand Health Insurance Experiment, Three Decades Later
Between 1974 and 1981, the RAND health insurance experiment provided health insurance to more than 5,800 individuals from about 2,000 households in six different locations across the United States, a sample designed to be representative of families with adults under the age of 62. More than three decades later, the RAND results are still widely held to be the "gold standard" of evidence for predicting the likely impact of health insurance reforms…
The Oregon Health Insurance Experiment
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage …
Selection in Insurance Markets
Government intervention in insurance markets is ubiquitous and the theoretical basis for such intervention, based on classic work from the 1970s, has been the problem of adverse selection. Over the last decade, empirical work on selection in insurance markets has gained considerable momentum. This research finds that adverse selection exists in some insurance markets but not in others. And it has uncovered examples of markets that exhibit "advant…
Insuring Long-Term Care in the United States
Long-term care expenditures constitute one of the largest uninsured financial risks facing the elderly in the United States and thus play a central role in determining the retirement security of elderly Americans. In this essay, we begin by providing some background on the nature and extent of long-term care expenditures and insurance against those expenditures, emphasizing in particular the large and variable nature of the expenditures and the e…
Input and Technology Choices in Regulated Industries
This paper examines the implications of regulatory change for the input mix and technology choices of regulated industries. We present a simple neoclassical framework that emphasizes the change in relative factor prices associated with the regulatory change from full cost to partial cost reimbursement, and investigate how this affects firms ’ technology choices through substitution of (capital embodied) technologies for tasks previously performed…
Adverse Selection in Insurance Markets
We use a unique data set of annuities in the United Kingdom to test for adverse selection. We find systematic relationships between ex post mortality and annuity characteristics, such as the timing of payments and the possibility of payments to the annuitant's estate. These patterns are consistent with the presence of asymmetric information. However, we find no evidence of substantive mortality differences by annuity size. These results suggest t…
Selection Effects in the United Kingdom Individual Annuities Market
This paper explores adverse selection in the voluntary and compulsory individual annuity markets in the United Kingdom. Two empirical regularities support standard models of adverse selection. First, annuitants are longer-lived than non-annuitants. These mortality differences are more pronounced in the voluntary than in the compulsory annuity market. We estimate that the amount of adverse selection in the compulsory market is about one half of th…
Adverse Selection in Insurance Markets
We use a unique data set of annuities in the United Kingdom to test for adverse selection. We find systematic relationships between ex post mortality and annuity characteristics, such as the timing of payments and the possibility of payments to the annuitant's estate. These patterns are consistent with the presence of asymmetric information. However, we find no evidence of substantive mortality differences by annuity size. These results suggest t…
The Value of Medicaid
We develop a set of frameworks for welfare analysis of Medicaid and apply them to the Oregon Health Insurance Experiment, a Medicaid expansion for low-income, uninsured adults that occurred via random assignment. Across different approaches, we estimate recipient willingness to pay for Medicaid between $0.5 and $1.2 per dollar of the resource cost of providing Medicaid; estimates of the expected transfer Medicaid provides to recipients are relati…
The Rand Health Insurance Experiment, Three Decades Later
Between 1974 and 1981, the RAND health insurance experiment provided health insurance to more than 5,800 individuals from about 2,000 households in six different locations across the United States, a sample designed to be representative of families with adults under the age of 62. More than three decades later, the RAND results are still widely held to be the "gold standard" of evidence for predicting the likely impact of health insurance reforms…
The Impact of Medicaid Expansion on Voter Participation
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and state administrative data on voter behavior, we analyze how a Medicaid expansion affected voter turnout and registration. We find that Medicaid increased voter turnout in the November 2008 Presidential election by about 7 percent overall, with the effects concentrated in men (18 percent increase)…
Selection in Insurance Markets
Government intervention in insurance markets is ubiquitous and the theoretical basis for such intervention, based on classic work from the 1970s, has been the problem of adverse selection. Over the last decade, empirical work on selection in insurance markets has gained considerable momentum. This research finds that adverse selection exists in some insurance markets but not in others. And it has uncovered examples of markets that exhibit "advant…
Insuring Long-Term Care in the United States
Long-term care expenditures constitute one of the largest uninsured financial risks facing the elderly in the United States and thus play a central role in determining the retirement security of elderly Americans. In this essay, we begin by providing some background on the nature and extent of long-term care expenditures and insurance against those expenditures, emphasizing in particular the large and variable nature of the expenditures and the e…
Selection Effects in the United Kingdom Individual Annuities Market
This paper explores adverse selection in the voluntary and compulsory individual annuity markets in the United Kingdom. Two empirical regularities support standard models of adverse selection. First, annuitants are longer-lived than non-annuitants. These mortality differences are more pronounced in the voluntary than in the compulsory annuity market. We estimate that the amount of adverse selection in the compulsory market is about one half of th…
Welfare Analysis Meets Causal Inference
We describe a frame work for empirical welfare analysis that uses the causal estimates of a policy's impact on net government spending. This framework provides guidance for which causal effects are (and are not) needed for empirical welfare analysis of public policies. The key ingredient is the construction of each policy's marginal value of public funds (MVPF). The MVPF is the ratio of beneficiaries' willingness to pay for the policy to the net …
Targeting Precision Medicine
Previous articleNext article No AccessTargeting Precision Medicine: Evidence from Prenatal ScreeningPeter Conner, Liran Einav, Amy Finkelstein, and Petra PerssonPeter Conner, Liran Einav, Amy Finkelstein, and Petra PerssonPDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookxLinkedInRedditEmailPrint SectionsMoreDetailsFiguresReferencesCited by Journal of Political Economy Just Accepted Article DOIhttps:/…
Input and Technology Choices in Regulated Industries
This paper examines the implications of regulatory change for the input mix and technology choices of regulated industries. We present a simple neoclassical framework that emphasizes the change in relative factor prices associated with the regulatory change from full cost to partial cost reimbursement, and investigate how this affects firms ’ technology choices through substitution of (capital embodied) technologies for tasks previously performed…
Selection Effects in the United Kingdom Individual Annuities Market
This paper explores adverse selection in the voluntary and compulsory individual annuity markets in the United Kingdom. Two empirical regularities support standard models of adverse selection. First, annuitants are longer-lived than non-annuitants. These mortality differences are more pronounced in the voluntary than in the compulsory annuity market. We estimate that the amount of adverse selection in the compulsory market is about one half of th…
Adverse Selection in Insurance Markets
We use a unique data set of annuities in the United Kingdom to test for adverse selection. We find systematic relationships between ex post mortality and annuity characteristics, such as the timing of payments and the possibility of payments to the annuitant's estate. These patterns are consistent with the presence of asymmetric information. However, we find no evidence of substantive mortality differences by annuity size. These results suggest t…
Input and Technology Choices in Regulated Industries
This paper examines the implications of regulatory change for the input mix and technology choices of regulated industries. We present a simple neoclassical framework that emphasizes the change in relative factor prices associated with the regulatory change from full cost to partial cost reimbursement, and investigate how this affects firms ’ technology choices through substitution of (capital embodied) technologies for tasks previously performed…
Selection in Insurance Markets
Government intervention in insurance markets is ubiquitous and the theoretical basis for such intervention, based on classic work from the 1970s, has been the problem of adverse selection. Over the last decade, empirical work on selection in insurance markets has gained considerable momentum. This research finds that adverse selection exists in some insurance markets but not in others. And it has uncovered examples of markets that exhibit "advant…
Insuring Long-Term Care in the United States
Long-term care expenditures constitute one of the largest uninsured financial risks facing the elderly in the United States and thus play a central role in determining the retirement security of elderly Americans. In this essay, we begin by providing some background on the nature and extent of long-term care expenditures and insurance against those expenditures, emphasizing in particular the large and variable nature of the expenditures and the e…
The Oregon Health Insurance Experiment
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage …
The Oregon Experiment — Effects of Medicaid on Clinical Outcomes
BACKGROUND: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. METHODS: Approximately 2 years after the lottery, we obtained data from 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who were not…
Income and Health Spending
Health expenditures as a share of GDP in the United States have more than tripled over the past half-century. A common conjecture is that this is a consequence of rising income. We investigate this hypothesis by instrumenting for local area income with time series variation in oil prices interacted with local oil reserves. This strategy enables us to capture both partial equilibrium and local general equilibrium effects of income on health expend…
The Rand Health Insurance Experiment, Three Decades Later
Between 1974 and 1981, the RAND health insurance experiment provided health insurance to more than 5,800 individuals from about 2,000 households in six different locations across the United States, a sample designed to be representative of families with adults under the age of 62. More than three decades later, the RAND results are still widely held to be the "gold standard" of evidence for predicting the likely impact of health insurance reforms…
Medicaid Increases Emergency-Department Use
Health Economy? The intensity of arguments over social science issues often seems inversely correlated with the quantity of experimental evidence. Taubman et al. (p. 263 , published online 2 January; see the Policy Forum by Fisman ) report on the latest analysis of an ongoing controlled experiment—the Oregon Health Insurance Experiment—that seeks to identify and quantify the effects of extending health insurance coverage to a low-income adult pop…
Moral Hazard in Health Insurance
Using data from employer-provided health insurance and Medicare Part D, we investigate whether healthcare utilization responds to the dynamic incentives created by the nonlinear nature of health insurance contracts. We exploit the fact that, because annual coverage usually resets every January, individuals who join a plan later in the year face the same initial ("spot") price of healthcare but a higher expected end-of-year ("future") price. We fi…
Sources of Geographic Variation in Health Care
We study the drivers of geographic variation in U.S. health care utilization, using an empirical strategy that exploits migration of Medicare patients to separate the role of demand and supply factors. Our approach allows us to account for demand differences driven by both observable and unobservable patient characteristics. Within our sample of over-65 Medicare beneficiaries, we find that 40–50% of geographic variation in utilization is attribut…
The Economic Consequences of Hospital Admissions
We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills, and bankruptcy, and reduce earnings, income, access to credit, and consumer borrowing. The earnings d…
The Value of Medicaid
We develop a set of frameworks for welfare analysis of Medicaid and apply them to the Oregon Health Insurance Experiment, a Medicaid expansion for low-income, uninsured adults that occurred via random assignment. Across different approaches, we estimate recipient willingness to pay for Medicaid between $0.5 and $1.2 per dollar of the resource cost of providing Medicaid; estimates of the expected transfer Medicaid provides to recipients are relati…
Take-Up and Targeting
We develop a framework for welfare analysis of interventions designed to increase take-up of social safety net programs in the presence of potential behavioral biases. We calibrate the key parameters using a randomized field experiment in which 30,000 elderly individuals not enrolled in—but likely eligible for—the Supplemental Nutrition Assistance Program (SNAP) are either provided with information that they are likely eligible, provided with thi…
The Impact of Medicaid Expansion on Voter Participation
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and state administrative data on voter behavior, we analyze how a Medicaid expansion affected voter turnout and registration. We find that Medicaid increased voter turnout in the November 2008 Presidential election by about 7 percent overall, with the effects concentrated in men (18 percent increase)…
Welfare Analysis Meets Causal Inference
We describe a frame work for empirical welfare analysis that uses the causal estimates of a policy's impact on net government spending. This framework provides guidance for which causal effects are (and are not) needed for empirical welfare analysis of public policies. The key ingredient is the construction of each policy's marginal value of public funds (MVPF). The MVPF is the ratio of beneficiaries' willingness to pay for the policy to the net …
Financial Incentives to Facilities and Clinicians Treating Patients With End-stage Kidney Disease and Use of Home Dialysis
ClinicalTrials.gov Identifier: NCT05005572
Long-Term Care Hospitals
There is substantial waste in U.S. healthcare but little consensus on how to combat it. We identify one source of waste: long-term care hospitals (LTCHs). Using the entry of LTCHs into hospital markets in an event study design, we find that most LTCH patients would have counterfactually received care at Skilled Nursing Facilities—facilities that provide medically similar care but are paid significantly less—and that substitution to LTCHs leaves p…
Why Is End-of-Life Spending So High? Evidence from Cancer Patients
We study the sources of high end-of-life spending for cancer patients. Even among patients with similar initial prognoses, spending in the year postdiagnosis is over twice as high for those who die within the year than those who survive. Elevated spending on decedents is predominantly driven by higher inpatient spending, particularly low-intensity admissions. However, most such admissions do not result in death, making it difficult to target spen…
Heterogeneity in Damages from a Pandemic
We use nationally-representative linked survey and administrative data to document socioeconomic and demographic disparities in the economic and health effects of the COVID-19 pandemic in the United States during its first two years. Impacts on all-cause mortality and on employment were concentrated in the same racial/ethnic, education, industry, and occupation groups. Black-White and Hispanic-White disparities in mortality impacts narrowed over …
A blueprint for U.S. health insurance policy
There is no shortage of proposals for U.S. health insurance reform. In our recent book, We've Got You Covered: Rebooting American Health Care (Einav & Finkelstein, 2023), we offered one more. It grew out of our internal debates over healthcare reform, between two academic economists who work (often together) on U.S. health policy but have not yet been involved in making that policy. We started by trying to define the goal: what is the problem tha…
Response to Jason Furman
We are pleased that Jason Furman responded to our proposal by recommending that the book (on which we base the proposal) should be “required reading by specialists and non-specialists alike” and noting that he “would be perfectly happy if [our] proposal were adopted.” Both comments are extremely gratifying to receive from a skilled and insightful economist, and particularly from someone who was involved—at the highest levels of the Obama Administ…
Targeting Precision Medicine
Previous articleNext article No AccessTargeting Precision Medicine: Evidence from Prenatal ScreeningPeter Conner, Liran Einav, Amy Finkelstein, and Petra PerssonPeter Conner, Liran Einav, Amy Finkelstein, and Petra PerssonPDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookxLinkedInRedditEmailPrint SectionsMoreDetailsFiguresReferencesCited by Journal of Political Economy Just Accepted Article DOIhttps:/…
The Effect of Medicaid on Crime
Those involved with the criminal justice system have disproportionately high rates of mental illness and substance-use disorders, prompting speculation that health insurance, by improving treatment of these conditions, could reduce crime. Using the 2008 Oregon Health Insurance Experiment, which randomly made some low-income adults eligible to apply for Medicaid, we find no statistically significant impact of Medicaid coverage on criminal charges …
Healthcare Policy and Management (19 obras) · Economics (18 obras) · Health care (15 obras) · Business (12 obras) · Medicine (12 obras) · Global Health Care Issues (11 obras) · Actuarial science (10 obras) · Economic growth (10 obras) · Health insurance (9 obras) · Medicaid (8 obras)