Health Care Access, Costs, and Treatment Dynamics: Evidence from In Vitro Fertilization

• 成果类型: Article
• 署名作者: Hamilton, Barton H.; Jungheim, Emily; McManus, Brian; Pantano, Juan
• 署名单位: Washington University (WUSTL); Washington University (WUSTL); University of North Carolina; University of North Carolina Chapel Hill; State University of New York (SUNY) System; Stony Brook University
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20161014
• 发表日期: 2018
• 页码: 3725-3777
• 关键词: infertility insurance mandates; EMBRYO-TRANSFER; UNITED-STATES; medical-care; coverage; rates; MODEL; AGE

摘要

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.