Essays on Health Economics and Consumer Finance

Chapter 1: Recently enacted state laws that limit how much hospitals can charge uninsured patients provide a unique opportunity to study how financial incentives of healthcare providers affect the care they deliver. Using an event study framework, we find that these fair pricing laws lead to a seven to nine percent reduction in the average length of hospital stay for uninsured patients. Although the longer-term effects of these care reductions are uncertain, they are not accompanied by worsening of short-term measures of quality of care. Overall, our results provide strong evidence that hospitals actively alter their behavior in response to financial incentives, and are consistent with the laws promoting a shift towards more efficient care delivery. Chapter 2: The list price for an average unit of care is more than three times what a hospital will be paid for treating a typical patient, and different hospitals charge widely different prices for the same service. These facts may seem innocuous, but many uninsured and out-of-network patients do pay list price. This paper uncovers patterns in hospital list prices, and explores several potential explanations. We find that markups vary much more across hospitals than within, but geography and quality of care explain little of the overall variation. Further, large, urban, well-equipped, for-profit hospitals have the highest list prices. A quirk in the Medicare Outlier Payment formula appears to have contributed to rapid price increases prior to 2004. Overall, our findings are consistent with more financially-sophisticated and profit-motivated hospitals more aggressively pursuing revenue from uninsured and out-of-network patients. Chapter 3: Many researchers and policy makers worry that Americans are not saving adequately for retirement. However, it is difficult to agree upon what constitutes adequate savings. This paper compares wealth accumulation patterns of different cohorts of Americans born in the first half of the 20th century. This comparative standard frames the retirement prospects of future and recent retirees in terms of the documented retirement experiences of older generations. Contrary to common perception, I find that the wealth accumulation of Americans nearing and entering retirement today is very similar to that of older generations.

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0501:Economics