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Working Paper
The influence of year-end bonuses on colorectal cancer screening
The objective of the paper is to estimate the effect of physician bonus eligibility on CRC screening while controlling for patient and primary care physician characteristics. The study is retrospective, using a managed care plan?s claims data on fifty-year-old commercially insured patients in the years 2000 and 2001. The data also include links to enrollment and provider files. Multivariate logistic regression models are used to assess the association between CRC screening receipt and physician bonus eligibility. The results indicate that the probability that a patient received a CRC ...
Working Paper
Cigarette smoking and food insecurity among low-income families in the United States, 2001
The goal of this research is to quantify the association between food insecurity and smoking among low-income families. This analysis is a retrospective study using data from the 2001 Panel Study of Income Dynamics, a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Family income is linked with U.S. poverty thresholds to identify 2,099 families living near or below 200 percent of the federal poverty level. Food insecurity (that is, having insufficient funds to purchase enough food to maintain an active and healthy ...
Working Paper
Smoking: taxing health and Social Security
While the health risks associated with smoking are well known, the impact on income distributions is not. This paper extends the literature by examining the distributional effects of a behavioral choice, in this case smoking, on net marginal Social Security tax rates (NMSSTR). The results show that smokers, as a result of shorter life expectancies, incur a higher NMSSTR than nonsmokers. In addition, as low-earnings workers have a higher smoking prevalence than high-earnings workers, smoking works to widen the income distribution. This higher tax rate could have implications for both labor ...
Working Paper
Incorporating insurance rate estimates and differential mortality into net marginal Social Security tax rate calculations
This paper extends the literature on net marginal tax rates created by the Social Security program by including variations in both the probability of being eligible to receive benefits and income-related life expectancy. The previous literature has found that women incur a lower net marginal tax rate because they have longer life expectancies. The results presented in this paper indicate that including variations in eligibility for benefits partially reverses this result by increasing net marginal Social Security tax rates for older women. In addition, the existing literature has shown that ...
Journal Article
Smoking: taxing health and Social Security
Cigarette smoking is costly in terms of not only its effects on smokers' health but also the direct and indirect financial costs it imposes on smokers and their families. For instance, premature death caused by smoking may redistribute Social Security income in unexpected ways that affect behavior and reduce the economic well-being of smokers and their dependents. ; This article examines the effects of smoking-attributable mortality on the net marginal Social Security tax rate (NMSSTR)?the difference between the statutory payroll tax rate and the present value of future benefits to which a ...
Journal Article
The quality of preventive and diagnostic medical care: why do southern states underperform?
As the cost of health care increases rapidly, the health care industry has turned its attention to methods of cost containment. However, concern exists that the drive to contain costs could lead to compromises in the quality of medical care. One practice that may slow the growth rate of health care expenditures and improve morbidity and mortality rates is the widespread use of preventive and diagnostic services. ; Using data compiled by the Centers for Medicare and Medicaid Services, this article evaluates the quality of care received by Medicare beneficiaries in each state. The authors ...
Working Paper
Does disability explain state-level differences in the quality of Medicare beneficiary hospital inpatient care?
Almost 20 percent of the total U.S. population and 42 percent of the population over the age of sixty-six are disabled. Research has shown that the presence of a disability can crowd out treatment for medical conditions not necessarily related to the disability and that states that are disproportionately African-American have a lower quality of hospital care. This paper uses quality of care data from the Centers for Medicare and Medicaid Services (CMS) to determine whether disability also explains state-level differences in quality of hospital care. The quality of Medicare beneficiary ...
Working Paper
A decomposition of the black-white differential in birth outcomes
Substantial racial disparities continue to persist in the prevalence of preterm births and low-birth-weight births. Health policy aimed at reducing these disparities could be better targeted if the differences in birth outcomes are better understood. This study decomposes these racial disparities in birth outcomes to determine the extent to which the disparities are driven by differences in measurable characteristics of black mothers and white mothers as well as the extent to which the gap results from differences in the impact of these characteristics. The analysis is focused on three ...