Economics Track |
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Contact Information Department of Health Care Policy Harvard Medical School 180 Longwood Ave. Boston, MA 02215 Email: lsabik@fas.harvard.edu Cell: 301-908-2353 Research Interests Health Economics, Health Policy, Health Services Research The Uninsured, Health Care Spending Growth Labor Economics, Public Finance >>CV |
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Selected Papers and Publications Job Market Paper"The Effect of Community Uninsurance Rates on Access to Health Care" Abstract: Recent literature has suggested that the rate of uninsurance in a market can have negative effects on access to care for both uninsured and insured individuals in the community. Previous studies considering the community effects of uninsurance have used cross-sectional data and may not have accounted for the role of other market factors in determining access to care or the potential endogeneity of the uninsurance rate. Using individual level data from the 1996 and 2003 waves of the Community Tracking Study, I investigate the effect of the uninsurance rate in a market on access to care for the uninsured and the insured using market fixed effects that control for time-invariant market characteristics. I use data from other sources, including the Area Resource File and the Bureau of Primary Healthcare Uniform Data System to consider the role of time-varying market-level factors on access for each of the groups. In addition, I use market level data on adjusted health care premium costs and unemployment levels to instrument for the uninsurance rate using a two-stage residual inclusion approach. Incorporating market and time effects in the models, I find that the causal effect of the rate of uninsurance in the community on access to necessary care for the uninsured is negative. In contrast, estimates for the insured are small and insignificant. Thus, policies that expand coverage to the uninsured may affect access to care for both the previously and continuously uninsured, particularly in communities that see a reduction from high rates of uninsurance. I find no evidence of spillovers to the insured, however, suggesting that such policy changes may have little effect on access to care for those who are already insured. Publications "Would Having More Primary Care Doctors Cut Health Spending Growth?" (with M. Chernew, A. Chandra and J. Newhouse) Health Affairs. Sept/Oct 2009; 28(5): 1327-1335. "The Dangerous Shortage of Domestic Violence Services," (with R. Iyengar) Health Affairs. 22 Sept 2009; 28(6): w1046-w1059. "Principles vs. Procedures in Making Health Care Coverage Decisions: Addressing Inevitable Conflicts," (with R. Lie) Theoretical Medicine and Bioethics. Apr 2008; 29(2): 73-85. "Priority Setting in Health Care: Lessons for the US from the Experiences of Six Countries," (with R. Lie) International Journal for Equity in Health. Jan 2008; 7(4). "Low-income Employees Choose Employment Benefits to Improve the Socio-Economic Determinants of Health," (with M. Danis, F. Lovett, K. Adikes, G. Cheng, T. Aomo) American Journal of Public Health. Sep 2007; 97(9): 1650-1657. "Informed Consent: Practices and Views of Investigators in a Multinational Clinical Trial," (with C. Pace, H. Forster, D. Wendler, J. Bebchuk, J. Tavel, L. McNay, J. Killen, E. Emanuel, C. Grady) IRB: Ethics & Human Research. Sep-Oct 2005; 27 (5): 13-18. |