Job Market Candidate
Department of Economics
579 Jane Stanford Way
Stanford, CA 94305
I will be available for interviews at:
- CEEE in Toronto, Canada (Dec 6-7)
- EEA in Rotterdam, Netherlands (Dec 18-19)
- ASSA in San Diego, California (Jan 3-5)
Job Market Paper
Can a Single Opioid Prescription Make a Difference? Evidence from Physician Prescribing Variation in Emergency Departments (with Sarah Eichmeyer)
In the past two decades, death rates from opioids have seen a fivefold increase and opioid prescribing has emerged as a leading public health problem in the United States. Clinical guidelines leave many opioid prescribing decisions to physician judgement; we study the extent to which a single opioid prescription in an emergency department, for these marginal cases, can induce long-term dependence and impact health and economic outcomes of a patient. We tackle these questions by leveraging quasi-random assignment of patients to physicians, who vary in their propensity to prescribe opioids. We analyze the universe of electronic health record data for a particularly vulnerable population—veterans—and find that a single opioid prescription can have strong adverse effects on a veteran's long-term outcomes. A single opioid prescription induces a 1.2 percentage point (pp) increase in the probability of long-term prescription opioid use, a 0.33pp increase in development of an opioid use disorder, and a 0.075pp increase in opioid overdose mortality. We find suggestive evidence of transition into illicit opioids. Moreover, in settings where the supply of legal prescription opioids is restricted, veterans are more likely to resort to illicit opioids, highlighting the complex interdependencies between legal and illicit sources of opioid supply.
What to Expect When You Are Expecting: Are Health Care Consumers Forward-Looking? (with Audrey Guo)
Journal of Health Economics, Vol 67, September 2019
A fundamental question in health insurance markets is how do health care consumers dynamically optimize their medical utilization under non-linear insurance contracts? Our paper tests the neoclassical prediction that a fully forward-looking agent only responds to their expected end-of-year price. Our unique identification strategy studies families during the year of childbirth who will likely satisfy their annual deductible, thereby knowing their expected end-of-year price. We find that during the year of a childbirth, fathers increase medical spending by 11% per month after their deductible is satisfied, rejecting the null of fully forward-looking consumers. This behavior cannot be explained by fathers increasing utilization in response to the childbirth itself. Furthermore, this myopia translates to a 21-24% decrease in total annual medical spending, relative to the counterfactual of fully forward-looking behavior, and is concentrated in elective procedures; we find no response in low value or urgent care. Our findings suggest the need for modeling non-linear incentives while accounting for myopic behavior when studying the medical utilization responses to health insurance.
Prescription Opioid Use and Health: Evidence from Primary Care [Coming Soon] (with Sarah Eichmeyer)
Health Insurance, Retirement Decisions, and the Value of Medicare
This paper presents new evidence on the effects of health insurance and Medicare eligibility on labor supply. There is a substantial portion of the population who retire at precisely the age of 65 even though Social Security no longer incentivize this age. Using non-parametric bunching estimators, I find this bunch can be explained by individuals who do not have employer-provided early retirement health insurance and thus would be uninsured if they retired before the Medicare eligibility age of 65. Given the importance of Medicare eligibility on retirement decisions, I build a retirement model to quantify the value (willingness-to-pay) of Medicare. Using observed income and retirement timing, I back out a value of Medicare of approximately $15,000 a year. With my retirement model, I estimate counterfactual retirement patterns under policy reforms such as shifting Medicare eligibility age and providing health insurance premium subsidies.
Work in Progress
Unpacking Opioid Prescribing Variation (with Sarah Eichmeyer)