Education and Health: Insights from International Comparisons, by David M. Cutler and Adriana Lleras-Muney (The National Bureau of Economic Research)
In this review we synthesize what is known about the relationship between education and health. A large number of studies from both rich and poor countries show that education is associated with better health. While previous work has thought of the effect of education separately for rich and poor countries, we argue that there are insights to be gained by integrating the two. For example, education is associated with lower malnutrition in most countries, but in richer countries the educated have lower BMIs whereas in poor countries the educated have higher BMIs. This suggests that the behaviors associated with better health differ depending on the level of development. We illustrate this approach by comparing the effects of education on various health and health behaviors around the world, to generate hypotheses about why education is so often (but not always) predictive of health. Finally, we review the empirical evidence on the relationship between education and health, paying particular attention to causal evidence and evidence on mechanisms linking education to better health.
Examining the Link between Cash Flow, Market Value, and Research and Development Investment Spending in the Medical Device Industry, by Bryan P. Schmutz and Rexford E. Santerre (Health Economics)
Unlike the pharmaceutical industry, no empirical research has focused on the factors influencing research and development (R&D) spending in the medical device industry. To fill that gap, this study examines how R&D spending is influenced by prior year cash flow and corporate market value using multiple regression analysis and a panel data set of medical device companies over the period 1962–2008. The empirical findings suggest that the elasticities of R&D spending with respect to cash flow and corporate market value equal 0.58 and 0.31, respectively. Moreover, based upon these estimates, simulations show that the recently enacted excise tax on medical devices, taken alone, will reduce R&D spending by approximately $4 billion and thereby lead to a minimum loss of $20 billion worth of human life years over the first 10 years of its enactment.
The Effect of National Health Insurance on Mortality and the SES–Health Gradient: Evidence from the Elderly in Taiwan, by Shao-Hsun Keng and Sheng-Jang Sheu
Using the difference-in-difference-in-differences method, we examine the effect of the National Health Insurance (NHI) on mortality, self-assessed health, and functional limitations of the elderly and seek to determine whether the effect is spread equally across health classes. We find that the NHI only has an effect on the death hazard, and it is the least healthy who benefit the most. The death hazard falls by 16–48% and 3–9% for the least health and the healthiest, respectively. The decline in the hazard ratio for the least healthy among the uninsured is 58% greater than that of their counterparts among the insured. Moreover, female participants benefit more from the NHI than male participants. We find no significant effect of the NHI in the SES–health gradient except for the education–death hazard gradient. The gap in the education-death hazard gradient between the insured and previously uninsured is significantly reduced by 7–31% after 1995. The hazard ratio among the less-educated in the treatment group also falls by 55% relative to that in the comparison group. The NHI appears to have prolonged lives but has failed to improve the functional limitations, which might have contributed to the rapid increase in the demand for long-term caregivers in recent years.
Addressing Requests by Patients for Nonbeneficial Interventions, by Allan S. Brett and Laurence B. McCullough (The American Journal of the Medical Association)
The Courts, Futility, and the Ends of Medicine, by Douglas B. White and Thaddeus M. Pope (The American Journal of the Medical Association)
A Prescription for Drug Shortages, by Barbara K. Gehrett (The American Journal of the Medical Association)