{"title":"Health Care in a Multi-Payer System: Spillovers of Health Care Service Demand among Adults under 65 on Utilization and Outcomes in Medicare","authors":"S. Glied, Kai Hong","doi":"10.2139/ssrn.2915169","DOIUrl":"https://doi.org/10.2139/ssrn.2915169","url":null,"abstract":"This paper examines, theoretically and empirically, how changes in the demand for health insurance and medical services in the non-Medicare population - coverage eligibility changes for parents and the firm size composition of employment - spill over and affect health insurance coverage and how these factors affect per beneficiary Medicare spending. We find that factors that increase coverage and hence demand for medical services in the non-Medicare population generate contemporaneous decreases in per beneficiary Medicare spending and utilization, particularly for high variation services. Moreover, these increases in the demand for medical services in the non-Medicare population are not associated with increases in the total quantity of physician services supplied. Finally, we find that the higher Medicare spending associated with lower insurance coverage rates in the non-Medicare population does not generate improvements in measures of Medicare patients' well-being, such as patient experience of care, ambulatory-care sensitive admissions, and mortality.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122140220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Public Education in the Dynamic City: Lessons from New York City","authors":"A. Schwartz, Leanna Stiefel","doi":"10.2139/ssrn.2716153","DOIUrl":"https://doi.org/10.2139/ssrn.2716153","url":null,"abstract":"The plight of urban schools and their failure to adequately and efficiently educate their students has occupied the national discussion about public schools in America over the last quarter century. While there is little doubt that failing schools exist in rural and suburban locations, the image of city school systems as under-financed, inefficient, inequitable and burdened by students with overwhelming needs is particularly well entrenched in the modern American psyche. As the largest school district in the country, New York City attracts particular attention to its problems. To some extent, this image reflects realities. New York City school children, like many urban students around the country, are more likely to be poor, non-white and immigrants, with limited English skills, and greater instability in their schooling, and the new waves of immigrants from around the world bring students with a formidable array of backgrounds, language skills, and special needs. The resulting changes in the student body pose particular challenges for schools. At the same time, despite a decade of school finance litigation and reform, New York continues to have trouble affording the class sizes, highly qualified teachers and other resources that suburban neighbors enjoy. Finally, there is evidence of continuing segregation and disparities in performance between students of different races and ethnicities.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114364540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Who are the Policy Workers and What Are They Doing? Citizen's Heuristics and Democratic Accountability in Complex Governance","authors":"Anthony M. Bertelli","doi":"10.1080/15309576.2016.1180306","DOIUrl":"https://doi.org/10.1080/15309576.2016.1180306","url":null,"abstract":"Two critical questions for the study of accountability in contemporary governance can focus attention on the citizen, rather than the official. I begin with the question of whether a citizen can identify a policy worker — that is, the bureaucrat, contractor, or other actor acting in pursuit of a legislated policy goal. I then turn to whether a citizen can evaluate policy work that is done to further a legislated policy goal. Both identification and evaluation prove tricky to assess in a great deal of policy work, leaving accountability an important, but elusive, democratic value. This paper provides a framework for analysts to understand when and why accountability works from a citizen’s perspective and what incentives policy workers and politicians have when it does.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132579524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do Homeowners Mark to Market? A Comparison of Self-reported and Estimated Market Home Values During the Housing Boom and Bust","authors":"Sewin Chan, Samuel R. Dastrup, I. Ellen","doi":"10.1111/1540-6229.12103","DOIUrl":"https://doi.org/10.1111/1540-6229.12103","url":null,"abstract":"This article examines homeowners’ self‐reported values in the American Housing Survey and the Health and Retirement Study from the start of the recent housing price run‐ups through recent price declines. We compare ZIP‐Code‐level market‐based estimates of housing prices to those derived from homeowners’ self‐reported values. We show that there are systematic differences which vary with market conditions and the amount of equity owners hold in their homes. When prices have fallen, homeowners systematically state that their homes are worth more than market estimates suggest, and homeowners with little or no equity in their homes state values above the market estimates to a greater degree. Over time, homeowners appear to adjust their assessments to be more in line with past market trends, but only slowly. Our results suggest that underwater borrowers are likely to understate their losses and either may not be aware that their mortgages are underwater or underestimate the degree to which they are.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131529789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Credit is Not a Right","authors":"John Gershman, J. Morduch","doi":"10.1017/CBO9781316275634.002","DOIUrl":"https://doi.org/10.1017/CBO9781316275634.002","url":null,"abstract":"Muhammad Yunus, the microcredit pioneer, has proposed that access to credit should be a human right. We approach the question by drawing on fieldwork and empirical scholarship in political science and economics. Evidence shows that access to credit may be powerful for some people some of the time, but it is not powerful for everyone all of the time, and in some cases it can do damage. Yunus’s claim for the power of credit access has yet to be widely verified, and most rigorous studies find microcredit impacts that fall far short of the kinds of empirical assertions on which his proposal rests. We discuss ways that expanding the domain of rights can diminish the power of existing rights, and we argue for a right to non-discrimination in credit access, rather than a right to credit access itself.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121206841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Flying Under the Radar? The State and the Enforcement of Labor Laws in Brazil","authors":"S. Coslovsky","doi":"10.2139/ssrn.2349113","DOIUrl":"https://doi.org/10.2139/ssrn.2349113","url":null,"abstract":"In recent years, developing countries have deregulated, privatized and liberalized their economies. Surprisingly, many of these countries have also retained or even strengthened their labor regulations. To understand how developing nations can ensure reasonable levels of labor protection without compromising the ability of domestic firms to compete in global markets, this paper examines how labor inspectors and prosecutors intervened in four troublesome industries in Brazil: charcoal; sugarcane; small-farming; and fireworks production. It finds that regulatory enforcement agents use their discretion and legal powers to realign incentives, reshape interests, and redistribute the risks, costs and benefits of compliance across an assemblage of public, private and non-profit agents adjacent to the violations. By doing so, they make compliance relatively easy, even desirable. Even more, as they perform this role, these agents become the foot-soldiers of a budding neo-developmental state.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128646523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is Micro Too Small? Microcredit vs. SME Finance","authors":"Jonathan Bauchet, J. Morduch","doi":"10.2139/ssrn.1971323","DOIUrl":"https://doi.org/10.2139/ssrn.1971323","url":null,"abstract":"Microcredit and small and medium enterprise (SME) finance are often pitched as alternative strategies to create employment opportunities in low-income communities. So far, though, little is known about how employment patterns compare. We integrate evidence from three surveys to show that, compared to Bangladeshi microcredit customers, typical SME employees in Bangladesh have more education and professional skills, and live in households that are notably less poor. SME jobs also require long work weeks, clashing with family responsibilities. The evidence from Bangladesh rejects the idea that SME finance more efficiently creates jobs for the population currently served by microcredit.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121079897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Substitution Bias and External Validity: Why an Innovative Anti-Poverty Program Showed No Net Impact","authors":"J. Morduch, S. Ravi, Jonathan Bauchet","doi":"10.2139/ssrn.2317322","DOIUrl":"https://doi.org/10.2139/ssrn.2317322","url":null,"abstract":"The net impact of development interventions can depend on the availability of close substitutes to the intervention. We analyze a randomized trial of an innovative anti-poverty program in South India which provides “ultra-poor” households with inputs to create a new, sustainable livelihood. We find no statistically significant evidence of lasting net impact on consumption, income or asset accumulation. Instead, income from the new livelihood substituted for earnings from wage labor. A very similar intervention made a large difference elsewhere in South Asia, however, where wage labor alternatives were less compelling. The analysis highlights the roles of substitution bias and dropout bias in shaping evaluation results and delimiting external validity.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114779206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leslie Santee Siskin, M. Weinstein, Robyn Sperling
{"title":"TO BE IB: Creating Support Structures and Services for Title I High Schools Implementing the International Baccalaureate Programme","authors":"Leslie Santee Siskin, M. Weinstein, Robyn Sperling","doi":"10.2139/SSRN.1874893","DOIUrl":"https://doi.org/10.2139/SSRN.1874893","url":null,"abstract":"The International Baccalaureate (IB) has a long record and a strong reputation for providing a “gold standard’ of rigorous academic programs and exam systems, and for preparing and certifying students around the world to be ready for university entry. To “be IB” has become a mark of distinction. With its demanding requirements and assessments, its academic and international orientation, and its aspirations for admission to highly selective universities, IB has often been seen as an “elite” program, but while the original Diploma Programme was often both elective and selective, the MYP and PYP are more intended to be whole school programs, open to all students.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115422655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Causality vs. Correlation: Rethinking Research Design in the Case of Pedestrian Environments and Walking","authors":"Zhan Guo","doi":"10.2139/ssrn.1573754","DOIUrl":"https://doi.org/10.2139/ssrn.1573754","url":null,"abstract":"This paper investigates the causal effect of pedestrian environments on walking behavior and focuses on the issue of research design. The paper differentiates between two types of research designs: treatment-based and traveler-based. The first approach emphasizes the variation of the treatment (pedestrian environments), and generally compares distinct neighborhoods, such as urban vs. suburban or transit-oriented vs. auto-dependent. The second approach emphasizes the homogeneity of subject (pedestrians), and aims at the same pedestrian under different environments normally due to home relocation, or the improvement of pedestrian environments. The first approach can easily identify a correlation between the pedestrian environment and walking, but proving it causal is a challenge. The second approach may not even find a correlation, but if it does, such a correlation is more likely to be causal. Which approach is better depends on whether the first approach can effectively control for the unobservable personal heterogeneity, and whether the second approach can find sufficient variation in the pedestrian environments experienced, arguably, by the same person. Most studies used the first approach but produced inconsistent results in terms of whether self-selection exists and if it does, whether it nullifies a causal relationship. This paper supports the second approach but argues that the few existing studies failed to capture sufficient variation of pedestrian environments in their research design. The paper then follows a traveler-based research design, and proposes a new method based on pedestrians’ path choice. By comparing the preference from the same pedestrian towards multiple walking paths with different pedestrian environments, this research is able to control the personal heterogeneity while still retain a sufficient variation in the pedestrian environments, thus represents a quasi-experimental design. It is able to do so because the path-based measure is sensitive enough to capture even minor differences in the pedestrian environment. More importantly, path choice is less likely to correlate with job and housing location choices, and therefore largely avoids the self-selection problem. In the empirical analysis, the paper targets subway commuters’ egress path choice from a station to their workplaces in downtown Boston. The results confirm a causal relationship and suggest that the pedestrian environment can significantly affect a person’s walking experience. The perceived utility change of walking, due to the sidewalk amenities, averages between 21 and 31 percent. In several street segments in downtown Boston, walking is actually perceived to have a positive utility instead of as a derived demand. Methodological issues regarding the method and generalizability of the findings are also discussed.","PeriodicalId":249319,"journal":{"name":"NYU Wagner School of Public Service Research Paper Series","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123976820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}