BISMARCK'S HEALTH INSURANCE AND THE MORTALITY DECLINE

• 成果类型: Article
• 署名作者: Bauernschuster, Stefan; Driva, Anastasia; Hornung, Erik
• 署名单位: University of Passau; University of Munich; University of Cologne
• 刊物名称: JOURNAL OF THE EUROPEAN ECONOMIC ASSOCIATION
• ISSN/ISSBN: 1542-4766
• DOI: 10.1093/jeea/jvz052
• 发表日期: 2020
• 页码: 2561-2607
• 关键词: infant health; life expectancy; public-health; regional differences; air-pollution; Germany; TRANSITION; IMPACT; water; fertility

摘要

We study the impact of social health insurance on mortality. Using the introduction of compulsory health insurance in the German Empire in 1884 as a natural experiment, we estimate difference-indifferences and regional fixed effects models exploiting variation in eligibility for insurance across occupations. Our findings suggest that Bismarck's health insurance generated a significant mortality reduction. Despite the absence of antibiotics and most vaccines, we find the results to be largely driven by a decline of deaths from infectious diseases. Further evidence suggests that statutory access to well-trained doctors was an elementary channel. This finding may be explained by insurance fund physicians transmitting new knowledge on infectious disease prevention.