Essays on health and tax policy.

摘要

This dissertation examines three dimensions of the economics of health in the context of public policy---the regulation of health insurance, the tax subsidies to health insurance purchase, and the indirect taxation of addictive health behaviors.;The first chapter considers the implications of regulating health insurance premiums on healthier individuals' incentives to purchase insurance. I use measures of individuals' expected health expenses to examine differences in the incentives faced by individuals when regulations require insurers to ignore specific dimensions of individual-specific health risks, including age and health status. In the context of community rating reforms in the United States, I find that, while premium regulation did not substantially alter the decision of healthier employees in small firms to purchase insurance, rating reforms may have discouraged younger participants and those in better health from being insured in the individual market.;The second chapter takes advantage of the variation in the after-tax price of health insurance induced by the income tax system in the United States to examine whether subsidies can mitigate the disincentives that premium regulations impose on the purchase of health insurance by healthier and younger individuals. I find that individuals are more likely to retain their private health insurance coverage if they receive a larger tax subsidy, but do not find substantial evidence of tax subsidies improving the incentives for healthier individuals to be covered in the small group or non-group markets subject to community rating.;Th final chapter examines the effect of product market taxation on addictive behaviors. Economic studies of taxation typically estimate external costs of tobacco use to be low, and refrain from recommending large tobacco taxes. The behavioral economic approach instead suggests that taxes can act as a self-control device to enable successful quit attempts. In a global context, whether taxes are successful at enabling more healthful behavior depends on how excessively people underweight the harm from tobacco use in different countries. Higher taxes therefore vary in their implications for equity in the context of health and public finance.