JEEA - Can Wealth Buy Health

<div><div>In this paper, we develop a life cycle model that features pecuniary and non-pecuniary investments in health in order to rationalize the socioeconomic gradients in health and life expectancy in the United States. Agents accumulate health capital, which affects labor productivity, utility, the distribution of medical spending shocks, and life expectancy. We find that unequal health insurance coverage plays a negligible role in generating the observed gaps in health and longevity. Universal health insurance increases preventive medical spending but not time spent in health promoting activities, as individuals are no longer worried about avoiding high curative medical expenditure shocks due to increased health insurance coverage. Our findings suggest that differences in lifetime income, preferences and health shocks are the main determinants of inequality in life expectancy.</div></div><br>

本文构建了一个包含健康的货币性与非货币性投入的生命周期模型，用以阐释美国健康与预期寿命层面的社会经济梯度差异。个体通过积累健康资本，而健康资本会影响劳动生产率、效用水平、医疗支出冲击的分布以及预期寿命。研究发现，医保覆盖的不平等对观测到的健康与寿命差距的影响微乎其微。全民医保会提升预防性医疗支出，但不会增加人们用于健康促进活动的时间——由于医保覆盖范围扩大，个体无需再为规避高额治疗性医疗支出冲击而担忧。本研究结论表明，终身收入、偏好与健康冲击的差异是预期寿命不平等的主要决定因素。