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Skinner, Jonathan

Works: 68 works in 468 publications in 2 languages and 3,217 library holdings
Roles: Author, Translator, Editor, Honoree
Classifications: HB1, 339.43
Publication Timeline
Publications about Jonathan Skinner
Publications by Jonathan Skinner
Most widely held works by Jonathan Skinner
Assessing the effectiveness of saving incentives by R. Glenn Hubbard( Book )
13 editions published between 1996 and 1997 in English and held by 219 libraries worldwide
In this paper, we argue that there is more to be learned from recent research on the effectiveness of targeted saving incentives than is suggested by the wide variation in empirical estimates. First, we conclude that characterizations of saving appear to stimulate moderate amounts of new saving. Second, we suggest a cost-benefit approach to ask: What is the incremental gain in capital accumulation per dollar of foregone revenue? We find that for quite conservative measures of the saving impacts of IRAs or 401(k)s, the incremental gains in capital accumulation per dollar of lost revenue are large
The incidence of Medicare by Mark B McClellan( Book )
12 editions published in 1997 in English and held by 87 libraries worldwide
Abstract: The Medicare program transfers more than $200 billion annually from taxpayers to beneficiaries. This paper considers the incidence of such transfers. First, we examine the net tax payments and program expenditures for individuals in different lifetime income groups. We find Medicare has led to net transfers from the poor to the wealthy, as a result of relatively regressive financing mechanisms and the higher expenditures and longer survival times of wealthier beneficiaries. Even with recent financing reforms, net transfers to the wealthy are likely to continue for at least several more decades. Second, we consider the insurance value of Medicare in providing a missing market for health insurance. With plausible parameter values, our simulations suggest that low-income elderly benefitted more than the dollar flows would suggest. Including this insurance value implies that, on net, there is faint redistribution from the highest income deciles to the lowest income deciles. We also consider the likely distributional impact of several proposed reforms in Medicare financing and benefits
How much is enough? : efficiency and medicare spending in the last six months of life by Jonathan Skinner( Book )
13 editions published in 1998 in English and held by 83 libraries worldwide
In Miami, average inpatient Medicare spending on people in their last six months of life was about double Medicare spending in Minneapolis; average ICU days were nearly four times higher. What are the implications of such differences for the efficiency of health care? In this paper, we used Medicare claims data to document the extent of these variations across 306 hospital referral regions in the U.S. We did not find strong evidence that the spending differences were due to underlying variation in health levels across regions. Nor did we find evidence of any benefits from higher spending levels; regional survival rates following acute conditions like AMI (heart attacks), stroke, and gastrointestinal bleeding were not correlated with more intensive health care spending. Finally, a number of recent studies suggest that people prefer less, rather than more intensive treatment. In sum, our results suggest that (i) regions providing more intensive care are not gaining net health benefits over regions providing less care, and (ii) allocative inefficiency may be present, in that patients are not necessarily matched with the treatment they prefer
Abandoning the nest egg? : 401(k) plans and inadequate pension saving by Andrew Samwick( Book )
20 editions published in 1996 in English and Undetermined and held by 81 libraries worldwide
There has been rapid growth in self-directed' pension programs such as the 401(k) plan. Because such plans are voluntary, there is concern that many workers neglecting to contribute will reach retirement with inadequate pension saving. First, we show that people who are eligible for 401(k)s, do not contribute to them, and have no alternative pension plan make up only 2-4 percent of the workforce. By contrast, nearly 50 percent of workers have no pension coverage at all. Imposing mandatory 3 percent or 5 percent contribution rates will improve retirement prospects among the lowest decile of pension- eligible, but would have small aggregate effects. Finally, restricting 401(k) withdrawals when the worker changes jobs could have a larger impact on retirement pension security
Do the rich save more? by Karen E Dynan( Book )
20 editions published in 2000 in English and held by 77 libraries worldwide
The issue of whether higher lifetime income households save a larger fraction of their income is an important factor in the evaluation of tax and macroeconomic policy. Despite an outpouring of research on this topic in the 1950s and 1960s, the question remains unresolved and has since received little attention. This paper revisits the issue, using new empirical methods and the Panel Study on Income Dynamics, the Survey of Consumer Finances, and the Consumer Expenditure Survey. We first consider the various ways in which life cycle models can be altered to generate differences in saving rates by income groups: differences in Social Security benefits, different time preference rates, non-homothetic preferences, bequest motives, uncertainty, and consumption floors. Using a variety of instruments for lifetime income, we find a strong positive relationship between personal saving rates and lifetime income. The data do not support theories relying on time preference rates, non-homothetic preferences, or variations in Social Security benefits. Instead, the evidence is consistent with models in which precautionary saving and bequest motives drive variations in saving rates across income groups. Finally, we illustrate how models that assume a constant rate of saving across income groups can yield erroneous predictions
Taxation and economic growth by Eric M Engen( Book )
15 editions published in 1996 in English and held by 77 libraries worldwide
Tax reforms are sometimes touted to have strong macroeconomic growth effects. We consider the impact of a major tax reform on the long-term growth rates of the U.S. economy using three approaches. The first approach is to examine the historical record of the U.S. economy to evaluate whether tax cuts have been associated with economic growth. The second is to consider the evidence on taxation and growth for a large sample of countries. And finally, we use evidence from micro-level studies of labor supply, investment demand, and productivity growth. Our results suggest modest effects, on the order of 0.2 to 0.3 percentage point differences in growth rates in response to a major tax reform that changes all marginal tax rates by 5 percentage points and average tax rates by 2.5 percentage points. Nevertheless, even such small effects can have a large cumulative impact on living standards
Precautionary saving and social insurance by R. Glenn Hubbard( Book )
14 editions published between 1994 and 1995 in English and German and held by 75 libraries worldwide
Microdata studies of household saving often find a significant group in the population with virtually no wealth, raising concerns about heterogeneity in motives for saving. In particular, this heterogeneity has been interpreted as evidence against the life-cycle model of saving. This paper argues that a life-cycle model can replicate observed patterns in household wealth accumulation after accounting explicitly for precautionary saving and asset-based means- tested social insurance. We demonstrate theoretically that social insurance programs with means tests based on assets discourage saving by households with low expected lifetime income. In addition, we evaluate the model using a dynamic programming model with four state variables. Assuming common preference parameters across lifetime- income groups, we are able to replicate the empirical pattern that low-income households are more likely than high-income households to hold virtually no wealth. Low wealth accumulation can be explained as a utility-maximizing response to asset-based means-tested welfare programs
What accounts for the variation in retirement wealth among U.S. households? by B. Douglas Bernheim( Book )
14 editions published in 1997 in English and Undetermined and held by 72 libraries worldwide
Household survey data consistently depict large variations in saving and wealth among households with similar socio-economic characteristics. Within the context of the life" cycle hypothesis, families with identical lifetime resources might choose to accumulate" different levels of wealth for a variety of reasons, including variation in time preference rates risk tolerance, exposure to uncertainty, relative tastes for work and leisure at advanced ages income replacement rates, and so forth. These factors can be divided into a small number of" classes, each with a distinctive implication concerning the relation between accumulated wealth" and the shape of the consumption profile. By examining this relation empirically for the presence or absence of these particular explanations for differences in wealth. Using" the Panel Study of Income Dynamics and the Consumer Expenditure Survey little support for life cycle models that rely on the above factors to explain wealth variation. " The data are, however, consistent with rule of thumb' or mental accounting' theories of" wealth accumulation
The distributional effects of Medicare by Julie Lee( Book )
12 editions published between 1998 and 1999 in English and held by 70 libraries worldwide
The Medicare program is now an important source of transfers to elderly and disabled beneficiaries, and will continue to grow rapidly in the future. Because the Medicare program is so large in magnitude, it can have significant redistributional effects. In this paper, we measure the flow of Medicare benefits to high-income and low-income neighborhoods in 1990 and 1995. We find that Medicare spending per capita for the lowest income groups grew much more rapidly than Medicare spending in either high income or middle income neighborhoods. Home health care spending played an important role in the increased spending among the lowest income neighborhoods. To our knowledge, this differential shift in spending has not been documented, yet it exceeds in magnitude the entire per capita transfer from the Earned Income Tax Credit (EITC) and is half of the average transfers to the elderly poor from Supplemental Security Income (SSI). Recent cutbacks in home health care benefits may undo some of this change. Still, this example illustrates how specific technical changes in Medicare policy can have redistributional effects comparable to major and much more visible expenditure and tax policies
Saving puzzles and saving policies in the United States by Annamaria Lusardi( Book )
15 editions published in 2001 in English and held by 68 libraries worldwide
In the past two decades the widely reported personal saving rate in the United States has dropped from double digits to below zero. First, we attempt to account for the decline in the National Income and Product Accounts (NIPA) saving rate. The macroeconomic literature suggests that about half of the drop since 1988 can be attributed to households spending stock market capital gains. Another thirty percent is accounting transfers from personal saving into government and corporate saving because of the way pensions and capital gains taxes are treated in the NIPA. Second, while NIPA saving measures are well suited for measuring the supply of new funds for investment and capital accumulation, it is not clear that they should be the target of government saving policies. Finally, we emphasize that the NIPA saving rate is not useful in judging whether households are preparing for retirement or other contingencies. Many households have accumulated significant wealth, primarily through retirement saving vehicles and capital gains, even as the saving rate slid. There remains a segment of the population, however, who save little and whose behavior appears untouched either by the stock market boom or the slide in personal saving. We explore reasons and policy options for their puzzlingly low saving rate
The efficiency of Medicare by Jonathan Skinner( Book )
12 editions published in 2001 in English and held by 65 libraries worldwide
Technological advances in health care have been shown to yield large average health benefits for the U.S. elderly population. However, less is known about the marginal or incremental benefits of health care spending. We use geographical variations in health care spending to measure the marginal value of greater health care intensity among the elderly Medicare population. To correct for the reverse causation problem -- that sicker areas tend to require more health care -- we use regional averages of physician visits in the last six months of life as a natural randomization for health care intensity. Using linear and semiparametric instrumental variables, we find that a large component of Medicare expenditures -- $26 billion in 1996 dollars, or nearly 20 percent of total Medicare expenditures -- appears to provide no benefit in terms of survival, nor is it likely that this extra spending improves the quality of life. While secular trends in health care technology have delivered large health benefits, variation in health care intensity at a point in time have not
Area differences in utilization of medical care and mortality among U.S. elderly by Victor R Fuchs( Book )
13 editions published in 2001 in English and held by 61 libraries worldwide
This paper examines 313 U.S. areas for differences in medical care utilization and mortality of whites ages 65-84 in 1990. The variables included in the analysis are education, real income, cigarette sales, obesity, air pollution, percent black, and dummy variables for seven regions and five population size categories from MSAs over 500,000 to not in MSA. Utilization, especially inpatient care, is strongly positively related to mortality. Mortality is positively related to cigarette sales, obesity, air pollution and percent black. Utilization (especially outpatient) is significantly higher in MSAs with populations greater than 500,000. Mortality does not vary with population size, with or without controls. Florida is an outlier for both utilization (very high) and mortality (by far the lowest of any region). The puzzles of Floridian exceptionalism and the positive relation between white mortality and percent black are discussed but not resolved
How will defined contribution pension plans affect retirement income? by Andrew Samwick( Book )
7 editions published in 1998 in English and held by 60 libraries worldwide
How has the emergence of defined contribution pension plans, such as 401(k)s, affected the financial security of future retirees? We consider this question using a detailed survey of pension formulas in the Survey of Consumer Finances. Our simulations show that average and median pension benefits are higher under defined contribution plans that for defined benefit plans. Defined benefit plans are slightly better at providing minimum benefits, but for plausible values of risk aversion, a defined contribution plan drawn randomly from those available in 1995 is still preferred to a defined benefit plan drawn randomly from those available in 1983. This result is robust to different assumptions regarding the spending of defined contribution balances between jobs, equity rates of return, and the date of retirement. In short, we suggest that defined contribution plans can strengthen the financial security of retirees
Is housing wealth a sideshow? by Jonathan Skinner( Book )
12 editions published in 1993 in English and held by 59 libraries worldwide
Do housing price fluctuations play an important role in the economic security of retirees, or is housing wealth just a sideshow to the determination of consumption and saving? Using panel data on saving from the Panel Study of Income Dynamics, and aggregate time- series data, I find that shifts in housing wealth do affect consumption and saving, especially for younger households. On the other hand, few elderly households appear to be tapping into their housing windfalls to finance retirement consumption. The precautionary saving approach can explain this puzzle. If housing wealth rises, households require less insurance against future contingencies, and will respond by spending more out of (nonhousing) wealth. But not every elderly household encounters a bad outcome requiring the liquidation of household equity. Hence the median elderly family will not actively spend housing windfalls. The theoretical and empirical results therefore suggest that housing wealth is not a sideshow
Geography and racial health disparities by Amitabh Chandra( Book )
10 editions published in 2003 in English and held by 54 libraries worldwide
An extensive literature has documented racial, ethnic, and socioeconomic disparities in health care and health outcomes. We argue that the influence of geography in medical practice needs to be taken seriously for both the statistical measurement of racial disparities, and in designing reforms to reduce disparities. Past research has called attention to disparities that occur within hospitals or provider groups; for example black patients who are treated differently from whites within a hospital. We focus on a different mechanism for disparities; African-Americans tend to live in areas or seek care in regions where quality levels for all patients, black and white, are lower. Thus ensuring equal access to health care at the local or hospital level may not by itself erase overall health care disparities. However, reducing geographic disparities in both the quality of care, and the quality of health care decisions by patients, could have a first-order impact on improving racial disparities in health care and health outcomes
Are for-profit hospitals really different? : Medicare upcoding and market structure by Elaine Silverman( Book )
12 editions published in 2001 in English and held by 53 libraries worldwide
How do for-profit and not-for-profit hospitals differ? We consider one dimension: the shifting of a patient's diagnostic related group (DRG) to one that yields a greater reimbursement from the Medicare system, also known as upcoding. It has played a major role in recent federal lawsuits against hospitals and hospital chains, but more importantly provides a valuable window for understanding how for-profit and not-for-profit hospitals make tradeoffs between pecuniary benefits and reputational or penalty costs. Our empirical work focuses primarily on hospital admissions involving pneumonia and respiratory infections; while the two diagnostic categories are often difficult to distinguish from one another, the latter pays about $2000 more to the hospital. Between 1989 and 1996, the incidence of the most expensive DRG (relative to all DRGs for pneumonia and respiratory infections) rose by 10 percentage points among stable not-for-profit hospitals, 23 percent among stable for-profit hospitals, and 37 percentage points among hospitals that had converted to for-profit status. (Since 1996, the upcoding index has dropped significantly in response to adverse publicity and lawsuits.) There is some evidence that not-for-profit hospitals operating in heavily for-profit markets were almost as likely to upcode as their for-profit brethren, as well as for important regional effects
The risk and duration of catastrophic health care expenditures by Daniel Feenberg( Book )
12 editions published in 1992 in English and held by 47 libraries worldwide
Catastrophic medical expenses are an important economic risk facing the elderly. Little is known about the persistence of such out-of-pocket medical costs. We measure the time-series property of medical costs using information on medical deductions from a panel of tax returns. During the period of analysis, 1968-73, taxpayers could deduct medical expenses above 3 percent of income. We correct for the resulting censoring bias using multivariate Tobit estimated with a variant of the smoothed simulated maximum likelihood (SSML) method. The data suggest that the burden of out-of-pocket medical expenses is substantially larger for lower income families. Furthermore, the estimated coefficients suggest substantial time-persistence in out-of-pocket medical care costs; a $1 increase in out-of-pocket medical spending is predicted to increase future spending by an additional $2.80. These results may shed light both on the social value of catastrophic health insurance as well on aggregate saving behavior
The measurement and evolution of healthy [sic] inequality : evidence from the U.S. Medicare population by Jonathan Skinner( Book )
7 editions published in 2004 in English and held by 44 libraries worldwide
Has U.S. health care for the elderly become more equitable during the past several decades? When inequality is measured by Medicare expenditures, the answer is yes. During 1987-2001, low income households experienced an increase of 78 percent ($2624) in per capita expenditures, double the increase of 34 percent ($1214) in the highest income group. When inequality is measured by life expectancy, the answer is no. Survival for the lowest income decile grew by 0.2 years during the 1990s compared to 0.8 years in the highest income group. That the two measures deliver such discordant messages may reflect their intrinsic shortcomings; expenditures depend on preferences, health status, and prices, while outcomes are strongly affected by health behavior and past illness. We suggest a new approach to measuring inequality: the use of quality-based effective care measures. For these measures, efficacy is well proven and nearly all of the relevant population should be receiving it, regardless of health status or preferences. Using Medicare claims data matched to zip code income, we find greater use of mammography screening, diabetic eye exams, and the use of blockers and reperfusion following heart attacks among higher income households, and these differences appear to be stable or growing slowly over time. In sum, the rapid relative growth in health care expenditures among low income elderly people has not translated into relative improvement either in survival or rates of effective care
Technology adoption from hybrid corn to beta blockers by Jonathan Skinner( Book )
10 editions published in 2005 in English and held by 40 libraries worldwide
"In his classic 1957 study of hybrid corn, Griliches emphasized the importance of economic incentives and profitability in the adoption of new technology, and this focus has been continued in the economics literature. But there is a distinct literature with roots in sociology emphasizing the structure of organizations, informal networks, and "change agents." We return to a forty-year-old debate between Griliches and the sociologists by considering state-level factors associated with the adoption of a variety of technological innovations: hybrid corn and tractors in the first half of the 20th century, computers in the 1990s, and the treatment of heart attacks during the last decade. First, we find that some states consistently adopted new effective technology, whether hybrid corn, tractors, or effective treatments for heart attacks such as Beta Blockers. Second, the adoption of these new highly effective technologies was closely associated with social capital and state-level 1928 high school graduation rates, but not per capita income, density, or (in the case of Beta Blockers) expenditures on heart attack patients. Economic models are useful in identifying why some regions are more likely to adopt early, but sociological barriers -- perhaps related to a lack of social capital or informational networks -- can potentially explain why other regions lag far behind"--National Bureau of Economic Research web site
Are you sure you're saving enough for retirement? by Jonathan Skinner( Book )
9 editions published in 2007 in English and held by 36 libraries worldwide
"Many observers believe current aging baby boomers are woefully unprepared for retirement. Others raise the prospect that Americans are saving too much for retirement. This paper attempts to reconcile these contrasting views using a simple life cycle model and a more sophisticated retirement program, ESPlanner, with special reference to retirement prospects for economists. I find most households with post-graduate degrees fall short of the wealth needed to smooth spending through retirement. Of course, there are ways to economize during retirement: stepping up household production (cooking at home rather than eating out), selling one's house, or maintaining the modest individual consumption levels from when children still roamed the house. But ultimately, I argue these laudable strategies to reduce retirement expenses will be dwarfed by rapidly growing out-of-pocket medical expenses. The combination of eroding retiree health benefits and the risk of catastrophic future out-of-pocket health spending suggests that even conventional retirement planning recommendations could be too low"--National Bureau of Economic Research web site
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Alternative Names
Skinner, Jonathan
Skinner, Jonathan S. 1955-
Skinner, Jonathan Snowden 1955-
English (249)
German (1)
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