Three Essays in Health, Education, and Retirement

In chapter one I examine the impact of Health Maintenance Organization (HMO) coverage on the provision of preventive medicine procedures and undiagnosed disease. Rates of missed preventive care and undiagnosed conditions are substantially lower for middle-aged HMO enrollees compared to non-HMO enrollees. I control for selection with a novel quasi-experiment: turnover in group health insurance contracts at the firm level creates exogenous variation in plan type. The large age heterogeneity in the effect of HMO contracts is consistent with incentive structures in HMOs playing a role in the quality of patient care. In chapter two I use a regression discontinuity framework to analyze the No Child Left Behind (NCLB) Act's attempt to reduce the achievement gap by requiring sociodemographic groups meet group based proficiency count targets. Using a panel of North Carolina public school students in grades three through eight from 2003-2012, I find when a student's group is added to the set of existing accountable groups, it has a small positive impact on subject matter proficiency and test scores. Variation in the application of these laws comes the fact that groups are only held to academic proficiency standards if there are 40 or more tested students in the group within the school. In chapter three I estimate the potential earnings of retirees. Estimating the earnings structure of those no longer working is complex, because (1) health and cognition decline at older ages and drive workers into retirement, (2) retirement may cause changes in health and cognition, and (3) unobserved wage shocks may also drive workers into retirement and bias estimates depending on the direction of selection. Issue (1) is solved by using health and cognitive measures from the data, the Health and Retirement Study. Issues (2)-simultaneity of retirement with health and cognition, and (3)-selection out of the labor force, are controlled for with four instruments, self-reported probability of retirement at age 62 and 65 reported at age 55 and age dummies for 62 and 65. We find that retirees would earn less than a selection corrected estimator would suggest by about $13,000 per year.

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