The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions

The U.S. population receives suboptimal levels of preventive care and has a high prevalence of risky health behaviors. One goal of the Affordable Care Act (ACA) was to increase preventive care and improve health behaviors by expanding access to health insurance. This paper estimates how the ACA‐facilitated state‐level expansions of Medicaid in 2014 affected these outcomes. Using data from the Behavioral Risk Factor Surveillance System, and a difference‐in‐differences model that compares states that did and did not expand Medicaid, we examine the impact of the expansions on preventive care (e.g., dental visits, immunizations, mammograms, cancer screenings), risky health behaviors (e.g., smoking, heavy drinking, lack of exercise, obesity), and self‐assessed health. We find that the expansions increased insurance coverage and access to care among the targeted population of low‐income childless adults. The expansions also increased use of certain forms of preventive care, but there is no evidence that they increased ex ante moral hazard (i.e., there is no evidence that risky health behaviors increased in response to health insurance coverage). The Medicaid expansions also modestly improved self‐assessed health.     

Covid19, Brexit and much more in 2020: A Bad Year for Animal Welfare?

Liverpool Law Review -     

The life satisfaction approach to valuing public goods: The case of terrorism

Terrorism has large social costs that are difficult to quantify for the well-known problems of eliciting people’s preferences for public goods. We use the LSA to assess these costs in utility and monetary terms. Based on combined cross-section time-series data, we estimate the costs of terrorism for France and the British Isles. We find large negative effects of terrorism on life satisfaction that translate into considerable compensating surpluses for a hypothetical reduction in terrorism, in particular for the serious conflict in Northern Ireland. The effects of terrorism are robust and differ across groups in accordance with prior expectations.     

Private Schools and the Parents that Choose Them: Empirical Evidence from the Danish School Voucher System

Research on the effect of school choice on student performance has generally been based on small-scale experiments or comparisons of Catholic and public schools in the United States. Recent studies indicate, however, that the market competition stemming from school vouchers does not affect all private schools equally. This study makes use of individual-level register data on the performance of more than 30,000 students in Denmark, where private schools have been voucher-financed for more than 100 years, while public schools are governed and financed by the politico-administrative system. Using an instrumental variable model to exclude selection effects, the results show no significant average effect of private schooling on final examination scores. However, a multilevel model shows that private schools of high socio-economic status perform better than similar public schools, while private schools of low socio-economic status under-perform – even for individual students with high socio-economic status. This indicates that the institutional setting of a voucher system is not enough to raise educational performance in general, arguably because some parents choose schools on the basis of non-academic criteria.     

Democracy as a Latent Variable

We apply formal, statistical measurement models to the Polity indicators, used widely in studies of international relations to measure democracy. In so doing, we make explicit the hitherto implicit assumptions underlying scales built using the Polity indicators. Modeling democracy as a latent variable allows us to assess the "noise" (measurement error) in the resulting measure. We show that this measurement error is considerable and has substantive consequences when using a measure of democracy as an independent variable in cross-national statistical analyses. Our analysis suggests that skepticism as to the precision of the Polity democracy scale is well founded and that many researchers have been overly sanguine about the properties of the Polity democracy scale in applied statistical work.     

Two-Level Security Management and the Prospects for New Democracies: A Simulation Analysis

Most new democracies face serious internal, ethnic/separatist conflicts; in addition, some face international threats. The literature on the growth of democracy in the global system and its impact on world politics does not fully account for the dual threats all states must address in managing their security. Based on theoretical work by Starr (1994) which describes the "common logic" of conflict processes in war and revolution, we outline a model of how states respond to security threats from both external and internal sources. Using computer simulation, we analyze the model and evaluate the relative importance for state security of factors such as system size, numbers of democracies in the system, extraction/allocation strategy pursued by new democracies, and government legitimacy level. Our results show that new democracies thrive in systems that are predominantly democratic. Also, ally support can provide crucial resources for new democracies facing internal threats. Finally, "endangered" democracies can recover security by attempting to buy off domestic threats rather than deter them, and by improving legitimacy.