Michael D. Frakes, Jonathan Gruber, Timothy Justicz
{"title":"Public and Private Options in Practice: The Military Health System","authors":"Michael D. Frakes, Jonathan Gruber, Timothy Justicz","doi":"10.1257/pol.20210625","DOIUrl":null,"url":null,"abstract":"Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hospitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better outcomes, suggesting marginal efficiency gains from care privatization. (JEL H51, H56, I11, I18, J13, L33)","PeriodicalId":48093,"journal":{"name":"American Economic Journal-Economic Policy","volume":"42 1","pages":"0"},"PeriodicalIF":5.6000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Economic Journal-Economic Policy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1257/pol.20210625","RegionNum":1,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hospitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better outcomes, suggesting marginal efficiency gains from care privatization. (JEL H51, H56, I11, I18, J13, L33)
期刊介绍:
The American Economic Review (AER) is a general-interest economics journal. The journal publishes 12 issues containing articles on a broad range of topics. Established in 1911, the AER is among the nation's oldest and most respected scholarly journals in economics.
American Economic Journal: Economic Policy publishes papers covering a range of topics, the common theme being the role of economic policy in economic outcomes. Subject areas include public economics; urban and regional economics; public policy aspects of health, education, welfare and political institutions; law and economics; economic regulation; and environmental and natural resource economics.