User Fee Abolition and the Demand for Public Health Care

This research examines the effect of the abolition of user fees in South Africa, a policy implemented in 1994 for uninsured children under the age of six and the elderly uninsured, as well as pregnant and nursing mothers. The analysis focuses on the implementation of the policy and the use of curative public healthcare services by children following strict and fuzzy regression discontinuity designs. The estimates point to statistically insignificant average and local average policy effects, even though the policy appears to have been implemented reasonably effectively, albeit imperfectly. In other words, the policy did not, on average, affect the use of curative public healthcare, at least for those children who should have benefited from the policy.     

Separating uncertainty from heterogeneity in life cycle earnings

This paper develops and applies a method for decomposing crosssection variability of earnings into components that are forecastableat the time students decide to go to college (heterogeneity)and components that are unforecastable. About 60% of variabilityin returns to schooling is forecastable. This has importantimplications for using measured variability to price risk andpredict college attendance.     

Policy Determinants of School Outcomes under Model Uncertainty: Evidence from South Africa

In this paper, we assess the determinants of secondary school outcomes in South Africa. We use Bayesian model averaging techniques to account for uncertainty in the set of underlying factors that are chosen among a very large pool of explanatory variables in order to identify the subset of explanatory variables most strongly associated with the dependent variable. Our analysis indicates that the socio‐economic background of pupils, demographic characteristics such as population groups (Black and White), as well as geographical locations account for a significant variation in pupils’ achievement levels. We also find that the most robust policy determinants of pupils’ test scores are the availability of a library at school, the use of IT in the classroom as well as school climate.     

Does health insurance decrease health expenditure risk in developing countries? The case of China

This article studies the impact of health insurance on individual out‐of‐pocket health expenditures in China. Using China Health and Nutrition Survey data between 1991 and 2006, we apply two‐part and sample selection models to address issues caused by censored data and selection on unobservables. We find that, although the probability of accessing health care increases with the availability of health insurance, the level of out‐of‐pocket health expenditure decreases. Our results from a selection model with instrumental variables suggest that having health insurance reduces the expected out‐of‐pocket health expenditure of an individual by 29.42% unconditionally. Meanwhile, conditional on being subjected to positive health expenditure, health insurance helps reduce out‐of‐pocket spending by 44.38%. This beneficial effect of health insurance weakens over time, which may be attributable to increases in the coinsurance rates of health insurances in China.     

Pandemic (COVID‐19) Policy,Regional Cooperation and the Emerging Global Production Network†

In this paper, we explore the possible policy responses to the COVID‐19 pandemic shock as well as the related economic (financial crisis) shocks on trade and global value chains (GVC) in East Asia. We find that regional policy coordination is critical to mitigate and isolate the pandemic shock. It is important to identify the pandemic events early to flatten the pandemic curve at the national and regional level. This supports a recent study by the World Bank (2020), which highlights the importance of early mitigation policies during the pandemic shock. The cost of the pandemic and economic shocks will increase significantly when several countries in the region experience the pandemic shock concurrently. In this case, flattening the regional pandemic curve becomes important. The results also indicate the need for greater coordination in East Asia to mitigate the pending economic shock in terms of unemployment, corporate bankruptcy and financial market fragility. The paper also highlights that the stability of the GVC network is critical during the pandemic in terms of hedging the risk of disruptions to the procurement of critical medical and health products as well as maintaining service linkages to manufacturing, such as the logistics sector. Regional policy coordination and the stability of GVC will be valuable in the post‐pandemic recovery of the region.     

Roles of rural non-farm employment (RNFE) in India: Why RNFE,the conveyor of a shock like COVID 19 is also the key to recovery?

We assess the role of Rural Non-Farm Employment (RNFE) in livelihoods and in likely impacts of shocks like COVID 19. In India’s agri-food system, the preponderance of small farmers with low endowments of human and financial capital implies that, RNFE has been the principal source of poverty reduction. Yet, RNFE is also the most adversely affected by shocks like COVID 19 and the measures adopted to prevent disease spread. To assess the roles of RNFE and possible effects of shocks, we uniquely utilize the recent rounds of nationally representative Periodic Labor Force Surveys (PLFS). To assess the “potential impact” of COVID 19 on workers, by using the large dataset, we match similar workers in different states of employment (SOE) where SOE may partly reflect the situation post shock. Job loss, reduction in work hours, movement across types of employment, casualization within RNFE is possible due to shocks to RNFE. We estimate that SOE in RNFE have significant association with poverty and income. With the data on COVID lockdown periods, we then validate the results to pair with the prospectively assessed impacts. Notwithstanding the effect of shocks, RNFE has the unique potential in recovery, being the prime rural income generator and risk mitigator apart from being characterized by comparatively high growth in female employment and in socially disadvantaged groups in India.     

Socioeconomic Determinants of Child Health: Empirical Evidence from Indonesia

This paper characterizes the socioeconomic determinants of child health using height‐for‐age z‐score (HAZ), a long‐run measure of chronic nutritional deficiency. We construct a panel data that follows children between ages 3 and 59 months in 1993 through the 1997 and 2000 waves of the Indonesian Family Life Survey. We use this data to identify the various child‐level, household‐level and community‐level factors that affect children's health. Our findings indicate that household income has a large and statistically significant role in explaining improvements in HAZ. We also find a strong positive association between parental height and HAZ. At the community level, we find that provision of electricity and the availability of paved roads are positively associated with improvements in HAZ. Finally, in comparison to community‐level factors, household‐level characteristics play a large role in explaining the variation in HAZ. These findings suggest that policies that address the demand‐side constraints have greater potential to improve children's health outcomes in the future.     

Faculty Gender in the College Classroom: Does It Matter for Achievement and Major Choice?

Many feel that faculty members of the same gender may serve as role models, helping students to perform better in classes and encouraging them to continue in a subject. However, while higher education research has found evidence of positive effects of matching on gender, there are also many findings of zero impact. The main hurdle in this literature is identifying the exogenous impact in the absence of student sorting by gender. This article addresses this difficulty by using institutional data from a private liberal arts institution to examine outcomes for students in courses taught by new faculty members for which the students would not know the gender before registering. Results provide evidence of a role model effect for both genders; students earn higher grades in courses taught by same‐gender instructors in fields traditionally dominated by the opposite gender. Major choice and course‐taking behavior are mostly unaffected by faculty gender.     

Farmers’ Willingness to Pay for a Tuberculosis Cattle Vaccine

We use contingent valuation (CV) and choice experiment (CE) methods to assess cattle farmers’ attitudes to and willingness to pay (WTP) for a bovine tuberculosis (bTB) cattle vaccine, to help inform vaccine development and policy. A survey questionnaire was administered by means of telephone interviews to a stratified sample of 300 cattle farmers in annually bTB‐tested areas in England and Wales. Farmers felt that bTB was a major risk for the cattle industry and that there was a high risk of their cattle getting the disease. The CE estimate produced a mean WTP of £35 per animal per single dose for a vaccine that is 90% effective at reducing the risk of a bTB breakdown and an estimated £55 for such a vaccine backed by 100% insurance of loss if a breakdown should occur. The CV estimate produced a mean WTP of nearly £17 per dose/per animal/per year for a vaccine (including 100% insurance) which, given the average lifespan of cattle, is comparable to the CE estimate. These WTP estimates are substantially higher than the expected cost of a vaccine which suggests that farmers in high risk bTB ‘hotspot’ areas perceive a substantial net benefit from buying the vaccine.     

Economic Perspectives on Nutrition Policy Evaluation

Too much food energy intake (relative to expenditure) and unbalanced diets are implicated in a range of diseases that impose major burdens on healthcare systems and cause pain and suffering. Governments have responded by introducing a range of measures, mainly targeting information and education, largely to children. However, more interventionist measures have been advocated and, in the past year, various food taxes have been introduced in Denmark, Hungary and France. The Address discusses evaluation of policies, particularly in the light of alternative theories of diet choice (rational choice, systematically irrational, automatic). The public health approach uses quality adjusted life years but fails to distinguish between private and social benefits and takes no account of the drivers of food choice behaviour. The economic approach, based on informed choice, makes the distinction between private and social benefits (if not always explicitly) but struggles to evaluate policies that change utility functions and with behavioural assumptions other than traditional rationality. Alternative assumptions and approaches could put the cost of unhealthy eating anywhere between £10 billion and £100 billion per annum in the UK. Evidence suggests that information measures (to perform or persuade) do not much change diets, nor do they tackle the externality element of unhealthy eating. They may, however, help change long‐term social norms. More interventionist measures like taxes improve social welfare (according to the compensation principle) and reduce health inequalities but are regressive, like all sin taxes. Almost all interventions pass cost‐effectiveness tests.