2012American Economic Journal Economic PolicyRequires access

The Doctor Might See You Now: The Supply Side Effects of Public Health Insurance Expansions

Craig Garthwaite

Open publisher page 85 citations

Abstract

In the United States, public health insurance programs cover over 90 million individuals. Expansions of these programs, such as the recently passed Patient Protection and Affordable Care Act (PPACA), may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program (SCHIP), physicians decreased the number of hours spent with patients, but increased their program participation. Suggestive evidence shows that this decrease resulted from shorter office visits. These findings are consistent with the predictions from a mixed-economy model of physician behavior and provide evidence of crowd out resulting from the creation of SCHIP. (JEL H75, I11, I13, I18)

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What this paper is about

In the United States, public health insurance programs cover over 90 million individuals. Expansions of these programs, such as the recently passed Patient Protection and Affordable Care Act (PPACA), may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program (SCHIP), physicians decreased the number of hours spent with patients, but increased their program participation. Suggestive evidence shows that this decrease resulted from shorter office visits. These findings are consistent with the predictions from a mixed-economy model of physician behavior and provide evidence of crowd out resulting from the creation of SCHIP. (JEL H75, I11, I13, I18)

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Available abstract

In the United States, public health insurance programs cover over 90 million individuals. Expansions of these programs, such as the recently passed Patient Protection and Affordable Care Act (PPACA), may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program (SCHIP), physicians decreased the number of hours spent with patients, but increased their program participation. Suggestive evidence shows that this decrease resulted from shorter office visits. These findings are consistent with the predictions from a mixed-economy model of physician behavior and provide evidence of crowd out resulting from the creation of SCHIP. (JEL H75, I11, I13, I18)

Key concepts: Health insurance, Patient Protection and Affordable Care Act, Public health insurance, Cover (algebra), State (computer science), Business, Public health, Health care

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