Job Market Paper
Does Medicare Part D Reduce Disparities in Health? (with Pinka Chatterji)
Over the past three decades an influx of new prescription drugs has transformed the treatment of chronic disease in the US and endowed the nation with a wide range of effective medications. However, historic progress in reducing mortality rates was recently reversed, educational and racial disparities in mortality persist, and gaps in life expectancy by education have widened in recent years. Attempting to shed light on these discordant facts, we examine whether a prescription drug benefit program can reduce education-related disparities in outcomes related to chronic diseases. Specifically, we investigate the effect of Medicare Part D on drug insurance coverage, medical utilization, and mortality, while also exploring these effects by education. We find that Part D is associated with increased drug insurance rates, greater utilization of prescription drugs, and decreased out-of-pocket spending. These improvements are magnified among low-educated individuals. Part D is associated with a mixed pattern of healthcare utilization that varies by education. Among low-educated individuals, the program increases outpatient care utilization, while among higher-educated individuals, it is associated with reductions in inpatient stays. These effects in medical utilization are translated into health benefits, as the prescription drug program reduces mortality and the effect is magnified among those with lower educational attainment. Our findings show that Medicare Part D increases medical utilization and reduces mortality among the elderly, especially for groups such as the low- educated elderly, who would otherwise lack drug insurance coverage.
In this paper, we examine changes in educational and labor market outcomes of Americans with disabilities between the late 1970s and the late 1990s by comparing the two cohorts of the NLSY. Our preliminary findings show that the gap in educational attainment between the disabled and non-disabled increases over time. For men, the increase in the educational attainment difference mainly comes from an increase in the difference in college graduation rates. For women, increases in gaps appear in high school graduation, college attendance, and college graduation rates. Further, we develop a theory of education investment for disabled students. The model suggests two motivating factors for education investment decisions: 1) the cost of obtaining education, 2) the incentive to signal their productivity through education in order to overcome employers’ uncertainty about disabled workers. That is, if obtaining education is too burdensome for the disabled, they will lose incentive to obtain education. But, if the effect of the uncertainty is strong, then the incentive to signal will be preserved well or even increase. Consequently, the educational attainment gap can be affected by the two conflicting forces.
Work in Progress
Does Research Change Prescribing Behavior? (with Sai Sindhura Gundavarapu)
Disproportionate Effects of the COVID Pandemic on People Scarred by the Great Recession
Learn to Walk by Learning to Fall in a Non-linear Price Schedule: Evidence from Medicare Part D