For some populations in the sample nations, health insurance does not provide adequate financial protection and likely contributes to inequities in health care delivery and outcomes.
This paper investigates achievement gaps between low and high socioeconomic students in 19 high-income countries. On average, math scores of students with indicators of high socioeconomic status (SES) are over one standard deviation above those with low SES indicators. The paper estimates the extent to which these achievement gaps can be attributed to differences in classroom-and schoollevel resources available to students from different SES backgrounds. In some countries, achievement gaps can be largely explained by differences in the characteristics of schools attended. However, in many other countries, the gap appears more closely related to differences in the characteristics of the students. The results point to the importance of institutional difference among countries in explaining international differences in the quality of education received by different groups within a nation. JEL classifications: I21; I28; I39
Background:This article compares the burden that medical cost-sharing requirements place on households in the United States and Canada. It estimates the probability that individuals with similar demographic features in the two countries have large medical expenses relative to income.Method:The study uses 2010 nationally representative household survey data harmonized for cross-national comparisons to identify individuals with high medical expenses relative to income. Using logistic regression, it estimates the probability of high expenses occurring among 10 different demographic groups in the two countries.Results:The results show the risk of large medical expenses in the United States is 1.5–4 times higher than it is in Canada, depending on the demographic group and spending threshold used. The United States compares least favorably when evaluating poorer citizens and when using a higher spending threshold.Conclusion:Recent health care reforms can be expected to reduce Americans’ catastrophic health expenses, but it will take very large reductions in out-of-pocket expenditures—larger than can be expected—if poorer and middle-class families are to have the financial protection from high health care costs that their counterparts in Canada have.
Considerable interest among academics and practitioners alike centers around identifying ways to improve voter turnout and voting parity across various subgroups in the U.S. population. Many scholars have investigated convenience voting and found mixed results in terms of its effects on turnout and its composition. A relatively new but unstudied method of voting is via ballot drop box, a method states and voters have increasingly turned to. We exploit the placement of over 30 new drop boxes in King County, Washington, the home of Seattle, during the 2016 election to investigate their effect on turnout. We find that distance to the closest ballot drop box increases one's probability of voting but primarily in off-year elections and primaries. We find mixed results for heterogeneous treatment effects. Implications are discussed.
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The Incidence of High Medical Expenses by Health Status in Seven Developed Countries AbstractHealth care policy seeks to ensure that citizens are protected against excessive out-of-pocket (OOP) expenses. Yet rising health care costs are pressuring private and social insurance schemes to shift toward more cost-sharing measures. This paper uses household surveys from seven countries to measure the burden of health expenditures for individuals with similar health conditions. It compares countries based on the extent to which citizens-those with health problems in particular-devote a large share of their income to medical expenses. The paper finds that in all countries but France, and to a lesser extent Slovenia, unhealthy citizens face considerably higher medical costs than do the healthy. As many as one-quarter of less healthy citizens in the U.S., Poland, Russia and Israel have large OOP expenses. The paper finds increased exposure to high medical expenses within countries is also associated with increased disparities between the unhealthy and healthy in the financial burden of OOP costs. The levels of high OOP spending uncovered, and their disparate weight on those with health problems (who are also disproportionately poor and elderly) underscore the potential for high OOP expenses to undermine core objectives of health care systems, including those of equitable financing, equal access, and improved medical outcomes.
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