Job quality, health insurance and the price of medical products: essays in applied economics

Qualité de l'emploi, assurance santé et prix des médicaments à l'hôpital: essais en économie appliquée

Lea Toulemon

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Abstract: This thesis focuses on two major aspects of individual well-being : job quality and the availability of medical care. We first investigate the long-term effects of job displacement on several dimensions of job quality. We use a coarsened exact matching method that takes into account time-invariant unobservables. Our main findings point to a deterioration of job quality after displacement. The magnitude and duration of the observed negative impact depends on the dimension considered. The second chapter studies the impact of a more generous public health insurance. We use the coexistence of two compulsory public health insurance systems in France, the national system, and the Alsace Moselle local system, which offers higher reimbursement rates. We investigate how moving to Alsace Moselle affects healthcare consumption, taking individuals who move between other French regions as a control group. Overall, we show that the Alsace Moselle local system does not increase healthcare consumption. The third chapter estimates the impact of group purchasing on medicine prices in French hospitals. We take advantage of the creation of regional purchasing groups between 2009 and 2014. We use a unique database that provides information on the average annual prices paid by public hospitals for all innovative medicines. Using a fixed effects model controlling for medicine-specific bargaining abilities of hospitals and medicine-specific price trends, we find that group purchasing reduces prices of medicines in oligopoly markets, but has no impact on prices of medicines for which there exist no competitors.

Keywords: Job quality; Health insurance; Impatient drug prices; Qualité de l'emploi; Assurance santé; Prix des médicaments hospitaliers (search for similar items in EconPapers)
Date: 2016-12-16
Note: View the original document on HAL open archive server: https://theses.hal.science/tel-03455279
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Published in Economics and Finance. Institut d'études politiques de paris - Sciences Po, 2016. English. ⟨NNT : 2016IEPP0041⟩

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