TY - JOUR
T1 - Health care access, costs, and treatment dynamics
T2 - Evidence from in vitro fertilization
AU - Hamilton, Barton H.
AU - Jungheim, Emily
AU - McManus, Brian
AU - Pantano, Juan
N1 - Publisher Copyright:
© 2018 American Economic Association.
PY - 2018/12
Y1 - 2018/12
N2 - We study public policies designed to improve access and reduce costs for in vitro fertilization (IVF). High out-of-pocket prices can deter potential patients from IVF, while active patients have an incentive to risk costly high-order pregnancies to improve their odds of treatment success. We analyze IVF's rich choice structure by estimating a dynamic model of patients' choices within and across treatments. Policy simulations show that insurance mandates for treatment or hard limits on treatment aggressiveness can improve access or costs, but not both. Insurance plus price-based incentives against risky treatment, however, can together improve patient welfare and reduce medical costs.
AB - We study public policies designed to improve access and reduce costs for in vitro fertilization (IVF). High out-of-pocket prices can deter potential patients from IVF, while active patients have an incentive to risk costly high-order pregnancies to improve their odds of treatment success. We analyze IVF's rich choice structure by estimating a dynamic model of patients' choices within and across treatments. Policy simulations show that insurance mandates for treatment or hard limits on treatment aggressiveness can improve access or costs, but not both. Insurance plus price-based incentives against risky treatment, however, can together improve patient welfare and reduce medical costs.
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U2 - 10.1257/aer.20161014
DO - 10.1257/aer.20161014
M3 - Review article
C2 - 30497124
AN - SCOPUS:85057571738
SN - 0002-8282
VL - 108
SP - 3725
EP - 3777
JO - American Economic Review
JF - American Economic Review
IS - 12
ER -