声明：本系列文章基于原期刊目录和摘要内容整理而得，仅限于读者交流学习。如有侵权，请联系删除。
《The Quarterly Journal of Economics》（经济学季刊）是经济学领域中历史悠久、最负盛名的期刊之一。它由哈佛大学经济系编辑，内容涵盖经济学领域的各个方面，对世界各地的经济学家、学者和学生来说是一个难以估量价值的期刊。该刊每年发行4期，每期发表文章12篇左右，2022-2023年影响因子为13.7。
本期目录
【2023】
Abe Dunn, Joshua D Gottlieb, Adam Hale Shapiro, Daniel J Sonnenstuhl, Pietro Tebaldi, A Denial a Day Keeps the Doctor Away, The Quarterly Journal of Economics, 2023;, qjad035,
【2022】
DellaVigna, S. et al. (2022) ‘Evidence on Job Search Models from a Survey of Unemployed Workers in Germany’, Quarterly Journal of Economics, 137(2), pp. 1181–1232.
Einav, L. et al. (2022) ‘Voluntary Regulation: Evidence from Medicare Payment Reform’, Quarterly Journal of Economics, 137(1), pp. 565–618.
【2021】
Miller, S., Johnson, N. and Wherry, L.R. (2021) ‘Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data’, Quarterly Journal of Economics, 136(3), pp. 1783–1829.
Abaluck, J. et al. (2021) ‘Mortality Effects and Choice Across Private Health Insurance Plans’, The quarterly journal of economics, 136(3), pp. 1557–1610.
Marinescu, I. and Skandalis, D. (2021) ‘Unemployment Insurance and Job Search Behavior’, Quarterly Journal of Economics, 136(2), pp. 887–931.
Goldin, J., Lurie, I.Z. and McCubbin, J. (2021) ‘Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach’, Quarterly Journal of Economics, 136(1), pp. 1–49.
【2020】
Jager, S. et al. (2020) ‘Wages and the Value of Nonemployment’, Quarterly Journal of Economics, 135(4), pp. 1905–1963.
Koijen, R.S.J. and Nieuwerburgh, S.V. (2020) ‘Combining Life and Health Insurance’, Quarterly Journal of Economics, 135(2), pp. 913–958.
A Denial a Day Keeps the Doctor Away
拒绝使得就医情况减少
作者
Dunn, Abe（美国经济分析局）; Gottlieb, Joshua D. （芝加哥大学，美国国家经济研究局）; Shapiro, Adam Hale（美国旧金山联邦储备银行）; Sonnenstuhl, Daniel J.（芝加哥大学）; Tebaldi, Pietro（哥伦比亚大学，美国国家经济研究局）
摘要：Who bears the consequences of administrative problems in health care? We use data on repeated interactions between a large sample of U.S. physicians and many different insurers to document the complexity of health care billing, and estimate its economic costs for doctors and consequences for patients. Observing the back-and-forth sequences of claim denials and resubmissions for past visits, we can estimate physicians’ costs of haggling with insurers to collect payments. Combining these costs with the revenue never collected, we estimate that physicians lose 18% of Medicaid revenue to billing problems, compared with 4.7% for Medicare and 2.4% for commercial insurers. Identifying off of physician movers and practices that span state boundaries, we find that physicians respond to billing problems by refusing to accept Medicaid patients in states with more severe billing hurdles. These hurdles are quantitatively just as important as payment rates for explaining variation in physicians’ willingness to treat Medicaid patients. We conclude that administrative frictions have first-order costs for doctors, patients, and equality of access to health care. We quantify the potential economic gains—in terms of reduced public spending or increased access to physicians—if these frictions could be reduced and find them to be sizable.
谁承担了医疗保健管理问题的后果？我们利用有关美国大量医生与许多不同保险公司之间重复互动的数据，来记录医疗保健账单的复杂性，并估算其对医生的经济成本和对患者造成的后果。通过观察过去就诊的拒赔和重新提交的来回记录，我们能够估算医生与保险公司讨价还价获取支付的成本。将这些成本与未收到的收入损失结合起来，我们估计医生由于账单问题损失了18%的医疗补助收入，对比于医疗照护（Medicare）和商业保险来说分别为4.7%和2.4%。通过研究医生跨州的流动与活动，我们发现，在有更严重账单问题的州，医生会通过拒绝医疗补助（Medicaid）患者来应对账单问题。这些问题在解释医生是否愿意接受医疗补助患者的差异中，与支付率有同等的重要性。我们得出结论，管理上的摩擦对医生、患者和平等获得医疗的成本具有重要影响。我们定量估算了如果能够减少这些摩擦所带来的潜在经济收益，无论是在减少公共支出方面还是增加与医生的接触机会上，都会是相当可观的。
原文链接：https://academic.oup.com/qje/advance-article/doi/10.1093/qje/qjad035/7209918
Evidence on Job Search Models from a Survey of Unemployed Workers in Germany
基于德国失业工人调查的求职模型的实证研究
作者
DellaVigna, Stefano(加州大学伯克利分校); Heining, Jorg(加州大学伯克利分校); Schmieder, Johannes F.(波士顿大学); Trenkle, Simon(IZA劳动研究所)
摘要：The job-finding rate of unemployment insurance (UI) recipients declines in the initial months of unemployment and then exhibits a spike at the benefit exhaustion point. A range of theoretical explanations have been proposed, but those are hard to disentangle using data on job finding alone. To better understand the underlying mechanisms, we conducted a large text-message-based survey of unemployed workers in Germany. We surveyed 6,349 UI recipients twice a week for four months about their job search effort. The panel structure allows us to observe how search effort evolves in individuals over the unemployment spell. We provide three key facts: (i) search effort is flat early on in the UI spell, (ii) search effort exhibits an increase up to UI exhaustion and a decrease thereafter, (iii) UI recipients do not appear to time job start dates to coincide with the UI exhaustion point. A standard search model with unobserved heterogeneity struggles to explain the second fact, and a model of storable offers is not consistent with the third fact. The patterns are well captured by a model of reference-dependent job search or by a model with duration dependence in search cost.
失业保险(UI)受益人的就业率在失业的最初几个月下降，然后在福利耗尽点出现峰值。人们提出了一系列的理论解释，但仅用求职数据很难理清这些解释。为了更好地理解潜在的机制，我们对德国的失业工人进行了一项基于短信的大型调查。我们进了每周两次、为期四个月的调查，对6349名失业保险受益者的求职情况进行了解。面板结构数据使我们能够观察到个人在失业期间的求职努力是如何演变的。我们提供了三个关键事实:（i）在失业保险期间的早期阶段，求职努力基本不变，(ii) 求职努力在失业保险用尽前增加，之后减少，(iii) 失业保险受益者似乎不会将就业开始日期安排在失业保险用尽时点。具有未观察到的异质性的标准模型难以解释第二个事实，而可存储的报价模型与第三个事实不一致。这些模式很好地被参照依赖的求职模型或搜索成本的持续期依赖模型所捕捉。
原文链接：https://academic.oup.com/qje/article/137/2/1181/6413570
Voluntary Regulation: Evidence from Medicare Payment Reform
自愿监管：来自医疗保险支付改革的证据
作者
Einav, Liran（斯坦福大学，美国国家经济研究局）; Finkelstein, Amy（斯坦福大学，美国国家经济研究局）; Ji, Yunan（哈佛大学）; Mahoney, Neale（斯坦福大学，美国国家经济研究局）
摘要：Government programs are often offered on an optional basis to market participants. We explore the economics of such voluntary regulation in the context of a Medicare payment reform, in which one medical provider receives a single, predetermined payment for a sequence of related healthcare services, instead of separate service-specific payments. This "bundled payment" program was originally implemented as a five-year randomized trial, with mandatory participation by hospitals assigned to the new payment model; however, after two years, participation was made voluntary for half of these hospitals. Using detailed claim-level data, we document that voluntary participation is more likely for hospitals that can increase revenue without changing behavior ("selection on levels") and for hospitals that had large changes in behavior when participation was mandatory ("selection on slopes"). To assess outcomes under counterfactual regimes, we estimate a stylized model of responsiveness to and selection into the program. We find that the current voluntary regime generates inefficient transfers to hospitals, and that alternative (feasible) designs could reduce these inefficient transfers and raise welfare. Our analysis highlights key design elements to consider under voluntary regulation.
政府计划通常以自愿参与的形式提供给市场参与者。我们在医疗保险支付改革的背景下探讨了这种自愿监管的经济学效应。在此改革中，一家医疗服务提供商对一系列相关医疗服务会收到一笔事先确定的支付，而非分开的针对不同服务的支付。这种“捆绑支付”模式起初实施是作为为期五年的随机试验实施，由指派到新支付模式下的医院强制参与；然而，在两年后，这些医院中有一半的参与变为自愿。利用详细的理赔水平数据，我们记录了自愿参与更有可能适用于那些可以在不改变行为的情况下增加收入的医院（“水平选择”），以及那些在强制参与的情况下行为发生重大变化的医院（“倾斜选择”）。为了评估在反事实情景下的结果，我们估计了一个关于对该计划的响应和选择的程式化模型。我们发现当前的自愿制度对医院进行了低效转移，并且替代（可行的）设计可能会减少这些低效的转移并提高福祉。我们的分析突显了在自愿监管下需要考虑的关键设计要素。
原文链接：https://academic.oup.com/qje/article/137/1/565/6372924
Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data
医疗补助与死亡率：来自联合调查和行政数据的新证据
作者
Miller, Sarah（密歇根大学）；Johnson, Norman（美国人口普查局）；Wherry, Laura R（纽约大学）
摘要：We use large-scale federal survey data linked to administrative death records to investigate the relationship between Medicaid enrollment and mortality. Our analysis compares changes in mortality for near-elderly adults in states with and without Affordable Care Act Medicaid expansions. We identify adults most likely to benefit using survey information on socioeconomic status, citizenship status, and public program participation. We find that prior to the ACA expansions, mortality rates across expansion and nonexpansion states trended similarly, but beginning in the first year of the policy, there were significant reductions in mortality in states that opted to expand relative to nonexpanders. Individuals in expansion states experienced a 0.132 percentage point decline in annual mortality, a 9.4% reduction over the sample mean, as a result of the Medicaid expansions. The effect is driven by a reduction in disease-related deaths and grows over time. A variety of alternative specifications, methods of inference, placebo tests, and sample definitions confirm our main result.
我们利用与行政死亡记录相连结的大规模联邦调查数据，研究了医疗补助登记与死亡率之间的关系。我们的分析比较了在是否有《平价医疗法案》（Affordable Care Act）医疗补助扩展的州中，近老年成年人死亡率的变化。我们利用有关社会经济地位、公民身份和公共计划参与的调查信息来识别最有可能受益的成年人。我们发现，在《平价医疗法案》扩展之前，扩展和非扩展州的死亡率趋势相似，但在政策实施的第一年，选择扩展的州相对于不扩展的州死亡率显著下降。在扩展的州中，由于医疗补助的扩大，个体年均死亡率下降0.132%，相对于样本均值而言，死亡率减少了9.4％。这一效果是由与疾病有关的死亡减少所驱动的，并且随着时间的推移而增加。各种替代规范、推断方法、安慰剂测试和样本定义都证实了我们的主要结果。
原文链接：https://academic.oup.com/qje/article-abstract/136/3/1783/6124639?redirectedFrom=fulltext
Mortality Effects and Choice across Private Health Insurance Plans
个人健康保险计划中的死亡率效应与选择
作者
Abaluck, Jason（耶鲁大学）; Caceres Bravo, Mauricio（布朗大学）; Hull, Peter（布朗大学）; Starc, Amanda（西北大学）
摘要: Competition in health insurance markets may fail to improve health outcomes if consumers are not able to identify high-quality plans. We develop and apply a novel instrumental variables framework to quantify the variation in causal mortality effects across plans and measure how much consumers attend to this variation. We first document large differences in the observed mortality rates of Medicare Advantage plans in local markets. We then show that when plans with high mortality rates exit these markets, enrollees tend to switch to more typical plans and subsequently experience lower mortality. We derive and validate a novel "fallback condition" governing the subsequent choices of those affected by plan exits. When the fallback condition is satisfied, plan terminations can be used to estimate the relationship between observed plan mortality rates and causal mortality effects. Applying the framework, we find that mortality rates unbiasedly predict causal mortality effects. We then extend our framework to study other predictors of plan mortality effects and estimate consumer willingness to pay. Higher-spending plans tend to reduce enrollee mortality, but existing quality ratings are uncorrelated with plan mortality effects. Consumers place little weight on mortality effects when choosing plans. Good insurance plans dramatically reduce mortality, and redirecting consumers to such plans could improve beneficiary health.
如果消费者无法识别高质量的健康保险计划，医疗保险市场的竞争可能无法改善健康结果。我们开发并应用了一个新颖的工具变量框架来量化不同计划之间因果死亡率效应的差异，并衡量消费者对这种差异的关注程度。首先，我们记录了在地方市场上医疗保险优势计划（Medicare Advantage plans）中观察到的死亡率的显著差异。然后，我们发现当死亡率高的计划退出这些市场时，参保人会选择更典型的计划从而降低死亡率。我们推导并验证了一个新的 "回退条件"，这个条件制约着那些被计划退出所影响的人的后续选择。当回退条件满足时，终止计划可以来估计可观察的计划死亡率与因果死亡效应之间的关系。应用这个框架，我们发现使用死亡率对因果死亡率效应进行预测是无偏的。然后，我们扩展框架来研究计划死亡率效应的其他预测因素，并估算了消费者的支付意愿。支出较高的计划会降低参保者的死亡率，但现有的质量评级与计划的死亡率效应并不相关。消费者在选择保险计划时很少考虑死亡率效应。良好的保险计划能显著降低死亡率，将消费者引导至这类计划可能有助于改善受益人的健康。
原文链接：https://academic.oup.com/qje/article-abstract/136/3/1557/6270892?redirectedFrom=fulltext
Unemployment Insurance and Job Search Behavior
失业保险与求职行为
作者
Marinescu, Ioana（宾夕法尼亚大学）; Skandalis, Daphne（哥本哈根大学）
摘要: How does unemployment insurance (UI) affect unemployed workers' search behavior? Search models predict that until benefit exhaustion, UI depresses job search effort and increases reservation wages. Over an unemployment spell, search effort should increase up to benefit exhaustion and stay high thereafter. Meanwhile, reservation wages should decrease up to benefit exhaustion and stay low thereafter. To test these predictions, we link administrative registers to data on job search behavior from a major online job search platform in France. We follow over 400,000 workers, as long as they remain unemployed. We analyze the changes in search behavior around benefits exhaustion and take two steps to isolate the individual response to unemployment benefits. First, our longitudinal data allows us to correct for changes in sample composition over the spell. Second, we exploit data on workers eligible for 12-24 months of UI as well as workers ineligible for UI, to control for behavior changes over the unemployment spell that are independent of UI. Our results confirm the predictions of search models. We find that search effort (the number of job applications) increases by at least 50% during the year preceding benefits exhaustion and remains high thereafter. The target monthly wage decreases by at least 2.4% during the year preceding benefits exhaustion and remains low thereafter. In addition, we provide evidence for duration dependence: workers decrease the wage they target by 1.5% over each year of unemployment, irrespective of their UI status.
失业保险（UI）如何影响失业工人的求职行为？求职模型预测，在获得失业救济金之前，失业保险会抑制求职努力并提高保留工资*。在整个失业期间，求职努力会在救济金耗尽之前增加，并在此后保持较高水平。与此同时，保留工资应该会在救济金耗尽之前减少，并在此后保持较低水平。为了验证这些预测，我们将行政登记数据与法国一家主要在线求职平台上的求职行为数据相结合。我们追踪了超过 40 万名失业工人，只要他们保持失业状态。我们分析了在救济金用尽前后的求职行为变化，并采取两个步骤来分离个体对失业救济金的反应。首先，我们的纵向数据使我们能够校正分析期间样本组成的变化。其次，我们利用有资格享受12-24个月失业保险工人以及没有资格享受失业保险工人的数据，来控制失业期间独立于失业保险的行为变化。我们的结果证实了求职模型的预测。我们发现，在救济金用尽前的一年内，求职努力（求职申请数量）至少增加了 50%，并在此后保持较高水平。目标月薪在救济金用尽前的一年内至少减少了 2.4%，并在此后保持较低水平。此外，我们还提供了持续时间依赖性的证据：在失业期间，无论工人的失业保险状况如何，他们每年都会将目标工资降低1.5%。
【*】保留工资（reservation wages），是指个人能够接受的最低工资。
原文链接：https://academic.oup.com/qje/article-abstract/136/2/887/5948104
Health Insurance and Mortality: Experimental Evidence from Taxpayer Outreach
健康保险与死亡率:来自纳税人外展的经验证据
作者
Goldin, Jacob(斯坦福大学); Lurie, Ithai Z.(美国财政部); McCubbin, Janet(美国财政部)
摘要：We evaluate a randomized outreach study in which the IRS sent informational letters to 3.9 million households that paid a tax penalty for lacking health insurance coverage under the Affordable Care Act. Drawing on administrative data, we study the effect of this intervention on taxpayers' subsequent health insurance enrollment and mortality. We find the intervention led to increased coverage during the subsequent two years and reduced mortality among middle-aged adults over the same time period. The results provide experimental evidence that health insurance coverage can reduce mortality in the United States.
我们评估了一项随机外展研究，该研究中美国国税局（IRS）向390万户未根据《平价医疗法案》(Affordable Care Act)要求购买健康保险而缴纳了税收罚款的家庭寄发了信息函。利用行政数据，我们研究了此干预措施对纳税人随后的健康保险购买和死亡率的影响。我们发现，在随后的两年里，干预措施增加了保险覆盖率，并降低了同期中年人的死亡率。结果提供了经验证据，证明在美国健康保险覆盖可以降低死亡率。
原文链接：https://academic.oup.com/qje/article/136/1/1/5911132
Wages and the Value of Nonemployment
工资与非就业价值
作者
Jger, Simon（麻省理工学院，国家经济研究局）；Schoefer, Benjamin（加利福尼亚大学伯克利分校）；Young, Samuel（麻省理工学院）；Zweimller, Josef（苏黎世大学）
摘要：Nonemployment is often posited as a worker’s outside option in wage-setting models such as bargaining and wage posting. The value of nonemployment is therefore a key determinant of wages. We measure the wage effect of changes in the value of nonemployment among initially employed workers. Our quasi-experimental variation in the value of nonemployment arises from four large reforms of unemployment insurance (UI) benefit levels in Austria. We document that wages are insensitive to UI benefit changes: point estimates imply a wage response of less than $0.01 per $1.00 UI benefit increase, and we can reject sensitivities larger than $0.03. The insensitivity holds even among workers with low wages and high predicted unemployment duration, and among job switchers hired out of unemployment. The insensitivity of wages to the nonemployment value presents a puzzle to the widely used Nash bargaining model, which predicts a sensitivity of $0.24–$0.48. Our evidence supports wage-setting models that insulate wages from the value of nonemployment.
非就业通常被假定为工资制定模型（如谈判和工资发布）中工人的外部选择。因此，非就业价值是工资的关键决定因素之一。我们衡量了最初就业的工人中非就业价值变化的工资影响。我们从奥地利进行的四次大规模失业保险（UI）福利水平改革中产生了非就业价值的准实验变动。结果显示，工资对失业保险福利变化不敏感：点估计表明，对每增加1.00美元的失业保险福利，工资的响应低于0.01美元，我们可以拒绝大于0.03美元的灵敏度。这种不敏感性甚至在工资较低且预计失业持续时间较长的工人以及从失业中被雇佣的工作切换者中也成立。工资对非就业价值的不敏感性对于广泛使用的纳什谈判模型提出了一个难题，该模型预测工资的敏感性为0.24美元至0.48美元。我们的证据支持那些将工资与非就业价值分割开来的工资制定模型。
原文链接：https://academic.oup.com/qje/article-abstract/135/4/1905/5838866
Combining Life and Health Insurance
寿险与医疗保险的融合
作者
Author: Koijen, Ralph S. J. （芝加哥大学，美国国家经济研究局和经济政策与研究中心）; Van Nieuwerburgh, Stijn（哥伦比亚大学，美国国家经济研究局和经济政策与研究中心）
摘要: We estimate the benefit of life-extending medical treatments to life insurance companies. Our main insight is that life insurance companies have a direct benefit from such treatments because they lower the insurer's liabilities by pushing the death benefit further into the future and raising future premium income. We apply this insight to immunotherapy, treatments associated with durable gains in survival rates for a growing number of cancer patients. We estimate that the life insurance sector's aggregate benefit from FDA-approved immunotherapies is $9.8 billion a year. Such life-extending treatments are often prohibitively expensive for patients and governments alike. Exploiting this value creation, we explore various ways life insurers could improve stress-free access to treatment. We discuss potential barriers to integration and the long-run implications for the industrial organization of life and health insurance markets, as well as the broader implications for medical innovation and long-term care insurance markets.
我们评估了寿命延长的医疗对寿险公司的利益。我们的主要发现是，寿险公司从这种寿命延长医疗中直接受益，因为它们通过死亡保险金的支付推迟并提高未来的保费收入来降低保险公司的负债。我们将这一见发现用于免疫疗法，即与不断增加的癌症患者存活率相关的治疗。我们估计，寿险行业每年从美国食品药品监督管理局批准的免疫疗法中获得的总收益为98亿美元。这种寿命延长的治疗方法对患者和政府来说往往昂贵得令人望而却步。利用这种价值创造，我们探索了各种寿险公司可以改善患者无压力接受治疗的各种方式。我们讨论了寿险和医疗保险融合的潜在障碍、对产业组织的长期影响，以及对医疗创新和长期护理保险市场的更广泛影响。
原文链接：https://academic.oup.com/qje/article-abstract/135/2/913/5626443
往期文章：
本文作者可以追加内容哦 !
