Bismarck's Health Insurance and the Mortality Decline

Erik Hornung, Stefan Bauernschuster and Anastasia Driva

No 12200, CEPR Discussion Papers from C.E.P.R. Discussion Papers

Abstract: We investigate the impact on mortality of the world's first compulsory health insurance, established by Otto von Bismarck, Chancellor of the German Empire, in 1884. Employing a multi-layered empirical setup, we draw on international comparisons and difference-in-differences strategies using Prussian administrative panel data to exploit differences in eligibility for insurance across occupations. All approaches yield a consistent pattern suggesting that Bismarck's Health Insurance generated a significant mortality reduction. The results are largely driven by a decline of deaths from infectious diseases. We present prima facie evidence that diffusion of new hygiene knowledge through physicians was an important channel.

Keywords: Health insurance; Mortality; Demographic transition; Prussian economic history (search for similar items in EconPapers)
JEL-codes: I13 I18 J11 N33 (search for similar items in EconPapers)
Date: 2017-08
New Economics Papers: this item is included in nep-hea, nep-his and nep-ias
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Citations: View citations in EconPapers (20)

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Related works:
Journal Article: Bismarck’s Health Insurance and the Mortality Decline (2020)
Working Paper: Bismarck's Health Insurance and the Mortality Decline (2018)
Working Paper: Bismarck's Health Insurance and the Mortality Decline (2017)
Working Paper: Bismarck's Health Insurance and the Mortality Decline (2017)
Working Paper: Bismarck’s Health Insurance and the Mortality Decline (2016)
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