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Who pays the high health costs of older workers? Evidence from prostate cancer screening mandates. (Bailey 2014)

Absence of conflict of interest.

Citation

Bailey, J. (2014). Who pays the high health costs of older workers? Evidence from prostate cancer screening mandates. Applied Economics, 46(32), 3931-3941. doi:10.1080/00036846.2014.948673

Highlights

  • The study examined the impact of state mandates that health insurance plans cover prostate cancer screenings on the earnings and employment of men older than age 50
  • The study used nonexperimental regression analyses to compare older men in states that had enacted a mandate with women, younger men, and older men living in states without a mandate. The author used data from the Current Population Survey(CPS) between 1990 and 2009.
  • The study found that older men in states with mandates had lower wages and were less likely than the comparison group to be employed.
  • The quality of causal evidence presented in this study is moderate, because it is a well-implemented nonexperimental study. This means we are somewhat confident that the estimated effects are attributable to the prostrate screening mandate, but other factors might also have contributed.

Intervention Examined

Prostate cancer screening mandates

Features of the Study

From 1992 to 2009, 30 states mandated that health insurance plans cover screening for prostate cancer. These mandates increase the costs of employing older male workers. The author used a difference-in-difference-in-difference model to estimate the impacts of mandates on the employment and earnings of men older than age 50 in states with a mandate relative to women, younger men, and men in states without a mandate. The analyses are based on 3.5 million observations in the CPS from 1990 (two years before the first mandate) to 2009. The analyses controlled for age, race, ethnicity, education, and marital status, as well as state and year fixed effects. In addition, the author estimated differences in earnings and employment between the groups in the two years before the mandate was enacted.

Findings

Employment

  • The author found that men older than age 50 who lived in a state where health insurance companies are mandated to cover prostate cancer screening were 2 percent less likely to be employed than men who lived in a state without the mandate.

Earnings

  • The author found that hourly wages for men older than age 50 who lived in a state where health insurance plans are mandated to cover prostate cancer screening were 2.8 percent lower than those for men who lived in a state without the mandate.

Causal Evidence Rating

The quality of causal evidence presented in this study is moderate, because it is a well-implemented nonexperimental study. This means we are somewhat confident that the estimated effects are attributable to the prostrate screening mandate, but other factors might also have contributed.

Reviewed by CLEAR

September 2019

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