UBC Theses and Dissertations

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UBC Theses and Dissertations

Essays on the economics of health and well-being Shiplett, Hugh


Is government guiding the invisible hand at the top of the labor market? Chapter 2 studies this question among physicians, the most common occupation among the top one percent of income earners. A novel linkage of population-wide tax records with the administrative registry of all physicians in the U.S. is used to study the characteristics of these high earnings, and the influence of government payments in particular. A major role is found for government on the margin, with half of direct changes to government reimbursement rates flowing directly into physicians’ incomes. These policies move physicians’ relative and absolute incomes more than any reasonable changes to marginal tax rates. At the same time, the overall level of physician earnings can largely be explained by labor market fundamentals of long work and training hours. Chapter 3 takes advantage of the sharp cutoff at age 26 in eligibility for medical insurance coverage on a parent’s plan under the Affordable Care Act’s dependent coverage mandate to identify the benefit of expanded coverage to individuals with health problems. Using a regression discontinuity design, Access to dependent coverage is shown to significantly reduce the subjective cost of ill-health for those under 26. The estimated effects are found to be very large in income equivalent, though not outside the realm of previous related estimates, and pass a variety of standard robustness checks. Strong versions of the set-point hypothesis argue that subjective well-being measures primarily reflect each individual’s own personality and that deviations are temporary. Chapter 4 uses international migration as a test. With or without adjustments for selection effects, the levels and distributions of immigrant life satisfaction scores for immigrants to the United Kingdom and Canada from up to 100 source countries mimic those in their destination countries, and even the destination regions within those countries, rather than those in their source countries, showing that subjective life evaluations are substantially driven by life circumstances, and respond when those circumstances change.

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