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1、DynamicIneffcienciesinEmployment-BasedHealthInsuranceSystem：TheoryandEvidenceDynamicInecienciesinEmployment-BasedHealthInsuranceSystem:TheoryandEvidenceHanmingFangxAlessandroGavazza{April30,2007Preliminaryandincomplete.Commentsarewelcome.WearegratefultoDaronAcemoglu,LuisCabra
2、l,AmyFinkelstein,IgalHendel,StephenMorris,AloysiusSiowandseminarparticipantsatUniversityofConnecticut,Rice/HoustonandTexasA&Mforaskingmanyusefulquestionsandforhelpfulsuggestions.Weareresponsibleforallshortcomings.xDepartmentofEconomicsandCowlesFoundation,YaleUniversity,P.
3、O.Box208264,NewHaven,CT06520-8264.Email:hanming.fang@yale.edu{SchoolofManagementandCowlesFoundation,YaleUniversity,P.O.Box208200,NewHaven,CT06520-8200.Email:alessandro.gavazza@yale.eduAbstractWeinvestigatehowU.S.employment-basedhealthinsurancesystemaectshealthcaredeci-sions.W
4、estressthathealthisaformofhumancapitalthataectsproductivityonthejobandwesuggestthatthecurrentU.S.systemmightleadtoaninecientlowlevelofindividualhealthduetoemployees'turnover.Turnoverinfrictionallabormarketscreatesanexternalitythatlim-itsemployer'andemployee'sab
5、ilitytoprivatelycapturethefullbenetsofhealthinvestments.Moreover,weshowthatunder-investmentinhealthispositivelyrelatedtotheturnoverrateoftheworkers'industryandincreasesmedicalexpenditureinretirement.Weprovideempiricalevidenceforthepredictionsofthemodelusingtwodatasets,th
6、eMedicalExpenditurePanelSurvey(MEPS)andtheHealthandRetirementStudy(HRS).InMEPS,wendthatemployersinindustrieswithhighturnoverratesaremuchlesslikelytooerhealthinsurancetotheirworkers.Whenemployersoerhealthinsurance,thecontractshavehigherdeductiblesandemployers'contribution
7、totheinsurancepremiumislowerinhighturnoverindustries.Moreover,workersinhighturnoverindustrieshavelowermedicalexpenditureandundertakelesspreventivecare.InHRS,insteadwendthatindividualswhowereemployedinhighturnoverindustrieshavehighermedicalexpenditurewhenretired.Wealsoevaluate
8、andcastdoubtonalternativeexplanations.JELClassicationNumbers:D84,D91
