Risk Adjustment for Health Insurance: Theory and Implications

This paper explores the potential for welfare-improving public risk adjustment in health insurance markets characterized by adverse selection. The optimal risk adjustment system is derived in a theoretical model under a range of assumptions regarding government information and market equilibrium. Special attention is focused on the interaction between risk adjustment and the private transfers that can occur in markets characterized by adverse selection. Risk adjustment has the potential to improve both equity and efficiency; however, it can also have the effect of crowding out private transfers.     

Estimating Optimal Dynamic Regimes: Correcting Bias under the Null

Abstract.  A dynamic regime provides a sequence of treatments that are tailored to patient-specific characteristics and outcomes. In 2004, James Robins proposed g –estimation using structural nested mean models (SNMMs) for making inference about the optimal dynamic regime in a multi-interval trial. The method provides clear advantages over traditional parametric approaches. Robins' g –estimation method always yields consistent estimators, but these can be asymptotically biased under a given SNMM for certain longitudinal distributions of the treatments and covariates, termed exceptional laws. In fact, under the null hypothesis of no treatment effect, every distribution constitutes an exceptional law under SNMMs which allow for interaction of current treatment with past treatments or covariates. This paper provides an explanation of exceptional laws and describes a new approach to g –estimation which we call Zeroing Instead of Plugging In (ZIPI). ZIPI provides nearly identical estimators to recursive g -estimators at non-exceptional laws while providing substantial reduction in the bias at an exceptional law when decision rule parameters are not shared across intervals.     

SOME REAL EVIDENCE ON THE REAL BILLS DOCTRINE VERSUS THE QUANTITY THEORY

Researchers interested in testing between the Real Bills doctrine and the Quantity Theory approach to inflation in the face of rapid, deficit-financing money growth are confronted by an observation equivalence problem. This paper identifies a data set which resolves the dilemma and tests the two inflation models. The results provide clear evidence supporting the Real Bills doctrine, that the value of assets backing money determines its value, over the Quantity Theory.     

THE LEGISLATIVE HISTORY OF THE SHERMAN ACT RE-EXAMINED

According to Robert Bork's influential analysis, the Sherman Act was expressly instituted by the 51st Congress to advance consumer welfare, but has often been misinterpreted by federal courts handing down anticonsumer decisions. This paper suggests that the political coalition backing the 1890 antitrust statute sought multiple social ends and did not faithfully seek to impose economic efficiency. The key evidence includes historical economic trends, congressional debate, the legislative agenda of Senator John Sherman, and the political conflict generated by the most contentious (and most electorally important) issue of the 51st Congress: the highly protectionist McKinley Tariff Act.     

SELF-INTEREST AND PUBLIC OPINION TOWARD SMOKING RESTRICTIONS AND CIGARETTE TAXES

A burgeoning literature suggests that self-interest has littleinfluence on policy preferences. In sharp contrast are the findingsdiscussed in this paper: we show that self-interest plays adecisive role in shaping attitudes toward smoking restrictionsand cigarette taxes. Data from two random samples of Californiaadults collected by the Field Institute in April 1987 and February1984 indicate that nonsmokers are far more enthusiastic abouttightening smoking restrictions and increasing cigarette taxesthan smokers, particularly heavy smokers. We conclude by discussingseveral explanations for the apparent discrepancy between theseresults and the pattern of null findings characteristic of theself-interest literature.