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We estimate the effects of hospital competition on the level of and the variation in quality of care and hospital expenditures for elderly Medicare beneficiaries with heart attack. We compare competition's effects on more-severely ill patients, whom we assume value quality more highly, to the effects on less-severely ill, low-valuation patients. We find(More)
Health care report cards—public disclosure of patient health outcomes at the level of the individual physician or hospital or both—may address important informational asymmetries in markets for health care, but they may also give doctors and hospitals incentives to decline to treat more difficult, severely ill patients. Whether report cards are good for(More)
CONTEXT Proponents of restrictions on malpractice lawsuits claim that tort reform will improve access to medical care. OBJECTIVE To estimate the effects of changes in state malpractice law on the supply of physicians. DESIGN Differences-in-differences regression analysis that matched data on the number of physicians in each state between 1985 and 2001(More)
The recent rise of specialty hospitals--typically for-profit firms that are at least partially owned by physicians--has led to substantial debate about their effects on the cost and quality of care. Advocates of specialty hospitals claim they improve quality and lower cost; critics contend they concentrate on providing profitable procedures and attracting(More)
In this paper, we estimate the effect of the tax preference for health insurance on health care spending using data from the Medical Expenditure Panel Surveys from 1996-2005. We use the fact that Social Security taxes are only levied on earnings below a statutory threshold to identify the impact of the tax preference. Because employer-sponsored health(More)
During the contest for Kansas attorney general in 2006, an organization sent out 6 pieces of mail criticizing the incumbent's conduct in office. We exploit a discontinuity in the rule used to select which households received the mailings to identify the causal effect of mail on vote choice and voter turnout. We find these mailings had both a statistically(More)
INTRODUCTION The Unified Medical Language System (UMLS) Knowledge Sources embody a rich source of medical knowledge. We sought to extract a portion of this knowledge by incorporating information about relationships between UMLS concepts into an existing problem list vocabulary. METHODS We matched terms from the coded problem list of The Medical Record(More)
Recent legislation has expanded the jurisdiction of the federal government over crimes that were traditionally prohibited only by state law. Previous work has neglected the potentially important role of prosecutors' incentives in allocating cases to the federal and state systems. We model the decision-making process of state and federal prosecutors, and,(More)
Although the direct costs of the medical liability system account for a small fraction of total health spending, the system's indirect effects on cost and quality of care can be much more important. Here, we summarise findings of existing research on the effects of the medical liability systems of Australia, the UK, and the USA. We find systematic evidence(More)
Forty-three of the fifty states of the United States have granted item veto authority to their governors as part of state constitutions. In this paper, I test explanations of why and when a legislature would cede institutional power. Using data from 1865 to 1994, I show that these measures are most likely proposed by fiscal conservatives who fear the loss(More)