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Private vs. public provision of social insurance : evidence from Medicaid

Author: Timothy J Layton; Nicole Maestas; Daniel Prinz; Boris Vabson; National Bureau of Economic Research,
Publisher: Cambridge, Mass. : National Bureau of Economic Research, 2019.
Series: Working paper series (National Bureau of Economic Research), no. 26042.
Edition/Format:   eBook : Document : EnglishView all editions and formats
Summary:
Public health insurance benefits in the U.S. are increasingly provided by private firms, despite mixed evidence on welfare effects. We investigate the impact of privatization in Medicaid by exploiting the staggered introduction of county-level mandates in Texas that required disabled beneficiaries to switch from public to private plans. Compared to the public program, which used blunt rationing to control costs, we  Read more...
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Details

Material Type: Document, Internet resource
Document Type: Internet Resource, Computer File
All Authors / Contributors: Timothy J Layton; Nicole Maestas; Daniel Prinz; Boris Vabson; National Bureau of Economic Research,
OCLC Number: 1109427452
Notes: "July 2019"
Description: 1 online resource (47, 32 pages) : illustrations, maps.
Series Title: Working paper series (National Bureau of Economic Research), no. 26042.
Other Titles: Private versus public provision of social insurance
Responsibility: Timothy J. Layton, Nicole Maestas, Daniel Prinz, Boris Vabson.

Abstract:

Public health insurance benefits in the U.S. are increasingly provided by private firms, despite mixed evidence on welfare effects. We investigate the impact of privatization in Medicaid by exploiting the staggered introduction of county-level mandates in Texas that required disabled beneficiaries to switch from public to private plans. Compared to the public program, which used blunt rationing to control costs, we find privatization led to improvements in healthcare--including increased consumption of high-value drug treatments and fewer avoidable hospitalizations--but also higher Medicaid spending. We conclude that private provision can be beneficial when constraints in the public setting limit efficiency.

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