***LONG DISCUSSIONS***
My discussion at AHEW 2021 on “Innovation and Health Disparities During an Epidemic: The Case of HIV” by B. Hamilton, A. Hincapié, E. Kalish, and N. Papageorge (Slides)
***PUBLICATIONS***
“A Comparison of Living Standards Across the United States of America,” with Vegard M. Nygaard (Draft, Slides, 30-second lighting talk), International Economic Review 64.2 (2023): 511-542.
We use an expected utility model to examine how living standards, or welfare, vary across the U.S. and how each state’s welfare has evolved over time. Our welfare measure accounts for cross-state variations in mortality, consumption, education, leisure, and inequality. We find that average living standards differ considerably across states. This is robust to allowing for endogenous interstate migration and to including housing in the model, and holds even when computing welfare conditional on education, gender, and race. Although states experienced heterogeneous welfare growth rates between 1999 and 2015 (ranging from 1.68 to 3.73 percent per year), there is no evidence of convergence in welfare levels, including during the sub-periods preceding and following the Great Recession. Whereas the level of real per-capita income is a good indicator of the level of welfare across states (correlation=0.75), the growth rate of real per-capita income is a poor proxy for the growth rate in welfare (correlation=0.42). Our welfare decomposition analysis can help identify what policies are likely to be most effective at increasing average living standards in the United States.
Presentations (by me or co-author, past and scheduled): Society of Government Economists Seminar Series (2021), 4th Workshop on Mechanism Design For Social Good (MD4SG ‘20, virtual due COVID-19), Society for Economic Dynamics (2020, rescheduled for 2021), European Economic Association Congress (2020), Board of Governors of the Federal Reserve System (2020), U.S. Bureau of Economic Analysis (2020), Texas Camp Econometrics XXV (2020)
In the media: Washington Post, Star Tribune, Heller-Hurwicz Economics Institute Policy Brief, FEDS Paper, FEDS Note, Brookings, Commissariat Général à la Stratégie et à la Prospective, Twitter thread, Just an Economist in Hawaii Blog
“Acts of Congress and COVID-19: A Literature Review on the Impact of Increased Unemployment Insurance and Stimulus Checks,” with Vegard M. Nygaard, chapter in The COVID-19 Pandemic: Ethical Considerations and Challenges, Ethics Press (March 2023).
“A Literature Review on the Impact of Increased Unemployment Insurance Benefits and Stimulus Checks in the United States,” with Vegard M. Nygaard (Covid Economics Issue, Draft, SSRN Version, FEDS Note), Covid Economics, Vetted and Real-Time Papers 64 (2021):186-201.
In the media: Econbrowser, MarketScreener
***NEWLY UPDATED!***
“Refining the Definition of the Unbanked,” with Vegard M. Nygaard (Draft, Slides)
We propose a new way to classify individuals without a bank account, accounting for their actual interest in being banked. Analogous to how unemployment statistics are defined and estimated, we differentiate the individuals that do not have a bank account and would like to have one (the “unbanked”) from individuals that do not have a bank account and are not interested in having one (the “out of banking population”). Using FDIC data, we show the evolution over time of these new measures and show that the two groups differ in policy-relevant ways. While the unbanked mostly cite financial and past credit or banking history problems as reasons for not having a bank account, the out of banking population cites a growing mistrust toward the traditional banking system. Policymakers should consider these factors when designing policies aimed at increasing financial inclusion.
Presentations (past and scheduled): System Payments Research Annual Conference (Virtual), Bank of Canada (Ottawa, Canada)
“The Determinants of Physicians’ Location Choice: Understanding the Rural Shortage” (Draft, Slides) [new draft coming soon!]
A long-standing challenge in the US health care system is the provision of medical services to rural areas. This paper develops a structural spatial equilibrium model with heterogeneous physicians and uses it to explore the impact of policies, namely loan forgiveness and salary incentives, on the geographical distribution of physicians. I collect micro data from physicians’ directories on their medical school, residency, and first-job choices and use this new dataset to both allow for physicians’ preference to remain close to their residency location and to implement an instrumental-variable approach to overcome endogeneity issues caused by the correlation between wages and unobserved amenities. I find that residents strongly prefer remaining close to their residency location. The combination of loan forgiveness and salary incentives have led to 1.2 percent more physicians choosing rural areas. Using the government spending currently allocated to loan forgiveness to further increase salary incentives would lead to 6 times more primary care physicians choosing rural areas and a higher average quality of rural physicians compared to the impact of current policies.
Presentations (past and scheduled): Royal Economic Society 2021 Annual Conference (online, due to COVID-19), LERA @ ASSA Chicago 2021, Annual Health Econometrics Workshop 2020 (online, due to COVID-19), Southern Economic Association Annual Meeting 2020 (online), APPAM International Conference 2020 (Toronto, Canada, moved to online), DC IO Day Conference 2020 (Washington, DC, moved to online), Midwest Economics Association Conference (Evanston, IL) 2018, American Society of Health Economists Conference (Atlanta, GA) 2018, Warwick Ph.D. Economics Conference (Warwick, United Kingdom) 2018, University of Minnesota (Minneapolis, MN) 2018, Simposio de la Asociación Española de Economía (Madrid, Spain) 2018, Board of Governors of the Federal Reserve System (Washington, DC) 2019, Wake Forest University (Winston-Salem, NC) 2019, McGill University (Montreal, Canada) 2019, Sciences Po (Paris, France) 2019, University of New South Wales (Sydney, Australia) 2019, International Industrial Organization Conference (Boston, MA) 2019, American Society of Health Economists Conference (Washington, DC) 2019, 3rd Workshop on Mechanism Design for Social Good (Phoenix, AZ) 2019, Urban Economics Association Conference (Philadelphia, PA) 2019
“The Consequences of Medicare Pricing: An Explanation of Treatment Choice” (Draft, Slides, 10m Video) [new draft coming soon!]
Primary care physicians (PCPs) provide more specialty procedures in less-urban areas, where specialists are fewer. Using a structural random-coefficient model and the demographic and time variation in the data, this paper shows that changes in policy-set reimbursements lead to a reallocation of the suddenly-more-remunerative procedures away from specialists and toward PCPs, and this effect is stronger, the more rural an area is. A reimbursement-unit increase for a given procedure leads to outside-metro PCPs gaining 7-15 percent market share more than metro PCPs in that procedure, at the expense of specialists. Small metropolitan areas and very rural areas are the most affected.
Presentations (past and scheduled): 4th Workshop on Mechanism Design For Social Good (MD4SG ‘20, virtual due COVID-19), APPAM International Conference 2020 (Toronto, Canada, moved to online), American Society of Health Economists Conference 2020 (St Louis, MO, moved to online), Missouri Valley Economic Association Conference (Kansas City, MO) 2017, Midwest Economics Association Conference (Cincinnati, OH) 2017, Midwest Economics Association Conference (Evanston, IL) 2018, American Society of Health Economists Conference (Atlanta, GA) 2018, Warwick Ph.D. Economics Conference (Warwick, United Kingdom) 2018
In the media: National Affairs
“The Impact of the Size of the Physician Workforce on Mortality” (Draft, Slides) [Latest Draft: September 2020]
Cities attract both more physicians and healthier people, but whether these two facts are causally related is yet to be determined, as many variables are correlated with both the physician concentration and health outcomes. This paper uses unidentifiable claims data from New Hampshire and treatment-effects analysis to address this question and finds that access to an additional physician per 10,000 residents leads to 4.5 saved lives per 100,000 residents. Using aggregate data and an instrumental-variable approach where I use the procedures carried out across areas joint with the policy-set reimbursement fees to instrument for the number of care providers, I show that these results generalize to the US as a whole. The results are robust to many specifications, to variations in the type of care providers considered, and to variations in how the instrument is constructed.
Presentations: Simposio de la Asociación Española de Economía (Alicante, Spain) 2019
In the media: National Affairs
“A Thorough Analysis of Norwegian Cement Cartel Experience,” (Rough Draft)
The Norwegian cement market has experienced two events which are of particular interest to economists: its cartel period, from 1921 to 1968, and its subsequent monopoly period. The legality of both arrangements provides us with data on the price collusion and decision making of the companies affected unlike other industries where cartel periods happened illegally. This has of course attracted the attention of economists in the past. Röller, Steen, and Sørgard have all shown interest in this phenomenon and they have all provided some explanation of the move from a cartel to a monopoly, reaching the conclusion that the monopoly was actually highly welfare improving under some assumptions. This paper seeks to relax all of these assumptions and shows that the move to a monopoly was not actually as welfare improving as previously shown. Moreover, the improvement is actually due to the increase in prices, and is not welfare improving for consumers. To do so, I go back to the baseline model and increasingly relax more and more assumptions, showing the end change in results. In particular, starting from the baseline model, I make export prices depend on the quantity of cement exported. Then, I let marginal costs increase in time. I further show two generalizations: first, the case in which the export price is below marginal cost; second, the case in which marginal costs are company-specific. I conclude by taking the generalized version and calculate the effect of the change in welfare.
“Corporate Valuation: Measuring the Value of Companies in Turbulent Times” (Wiley 2016)
Buy the textbook I edited and contributed to here!
Other Work in Progress:
“An NP a Day Keeps the Doctor Away,” in progress.
In this paper, I analyze the effect of independent practice of nurse practitioners. In states where nurse practitioners can work independently (currently 23 out of 50), they tend to be more present in places where primary care physicians are lacking. By doing so, they can carry out more of those visits that physicians would normally carry out in cities. The location choice of nurse practitioners is therefore influenced by this margin when they are free to operate without supervision. First, I show that independent practices of nurse practitioners are particularly prevalent in rural areas and in health professional shortage areas in states where their independent practices are allowed. In states where this is not the case, nurse practitioners are concentrated in cities, as they are subject to physicians’ supervision. Because of this, policy changes that allow nurse practitioners to operate independently can be beneficial as they increase the provision of health care to areas which are not covered by physicians. However, the presence of nurse practitioners can subsequently deters physicians’ entry. Due to nurse practitioners’ more limited scope of practice compared to primary care physicians, the number of types of procedures carried out can in fact decrease. I conclude by analyzing which of these two effects is the strongest.
Older Work (Pre-PhD):
“High Product Complexity with Low Financial Literacy in a World of Rationally Bounded Individuals,” MSc Thesis, July 2015, Bocconi University (Draft)
This thesis combines the concepts of bounded rationality, product complexity, obfuscation, and trust to build a theoretical model which attempts to answer the following question: why do financially illiterate individuals hold highly complex financial products? In my thesis, investors have different degrees of sophistication, with unsophisticated investors being rationally bounded; financial institutions are able to exploit these differences to maximize their profits leading to discriminatory pricing of those product characteristics unobserved by unsophisticated individuals. Having to deal with the possibility of contamination between the two groups, financial institutions solve for the optimal time to reshuffle their product offerings, resetting the proportion of unsophisticated individuals back to the original one. Trust, proxied by the number of years the consumer has been dealing with the same financial intermediary, leads to high switching costs for unsophisticated investors. The latter are then eager to pay a higher price than the fair one, even after learning has occurred. If investors trust financial institutions, the latter are able to earn positive profits in equilibrium without the use of obfuscation (the absence of reshuffling of their products to eliminate the benefits unsophisticated investors obtain from learning). Limiting myself to a Bertrand setting, I can solve for equilibrium prices and consumers’ and financial institutions’ behavior when the complexity of products is not too high. Despite this restriction, the results found can be interesting if applied to products which can be easily compared across institutions, such as mortgages.