NBER Publications by William H. Dow

One goal of government health insurance programs is to improve health, yet little is known empirically about how important such government interventions can be in explaining health transitions. We analyze the child mortality effects of a major health insurance expansion in Costa Rica. In contrast to previous work in this area that has used aggregated ecological designs, we exploit census data to estimate individual-level models. Theoretical and empirical econometric results indicate that aggregation can introduce substantial upward biases in the insurance effects. Overall we find a statistically significant but quite small effect of health insurance on child mortality in Costa Rica.

This paper provides a theoretical and empirical investigation of the positive complementarities between disease-specific policies introduced by competing risks of mortality. The incentive to invest in prevention against one cause of death depends positively on the level of survival from other causes. This means that a specific public health intervention has benefits other than the direct medical reduction in mortality: it affects the incentives to fight other diseases so the overall reduction in mortality will, in general, be larger than that predicted by the direct medical effects. We discuss evidence of these cross-disease effects by using data on neo-natal tetanus vaccination through the Expanded Programme on Immunization of the World Health Organization.