Essays on health care reform, wealth inequality, and demography
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Tese |
Idioma: | eng |
Título da fonte: | Repositório Institucional do FGV (FGV Repositório Digital) |
Texto Completo: | https://hdl.handle.net/10438/16498 |
Resumo: | This thesis contains three chapters. The first chapter uses a general equilibrium framework to simulate and compare the long run effects of the Patient Protection and Affordable Care Act (PPACA) and of health care costs reduction policies on macroeconomic variables, government budget, and welfare of individuals. We found that all policies were able to reduce uninsured population, with the PPACA being more effective than cost reductions. The PPACA increased public deficit mainly due to the Medicaid expansion, forcing tax hikes. On the other hand, cost reductions alleviated the fiscal burden of public insurance, reducing public deficit and taxes. Regarding welfare effects, the PPACA as a whole and cost reductions are welfare improving. High welfare gains would be achieved if the U.S. medical costs followed the same trend of OECD countries. Besides, feasible cost reductions are more welfare improving than most of the PPACA components, proving to be a good alternative. The second chapter documents that life cycle general equilibrium models with heterogeneous agents have a very hard time reproducing the American wealth distribution. A common assumption made in this literature is that all young adults enter the economy with no initial assets. In this chapter, we relax this assumption – not supported by the data – and evaluate the ability of an otherwise standard life cycle model to account for the U.S. wealth inequality. The new feature of the model is that agents enter the economy with assets drawn from an initial distribution of assets. We found that heterogeneity with respect to initial wealth is key for this class of models to replicate the data. According to our results, American inequality can be explained almost entirely by the fact that some individuals are lucky enough to be born into wealth, while others are born with few or no assets. The third chapter documents that a common assumption adopted in life cycle general equilibrium models is that the population is stable at steady state, that is, its relative age distribution becomes constant over time. An open question is whether the demographic assumptions commonly adopted in these models in fact imply that the population becomes stable. In this chapter we prove the existence of a stable population in a demographic environment where both the age-specific mortality rates and the population growth rate are constant over time, the setup commonly adopted in life cycle general equilibrium models. Hence, the stability of the population do not need to be taken as assumption in these models. |
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Gomes, Diego Braz PereiraEscolas::EPGECosta, Carlos Eugênio Ellery Lustosa daSantos, Cézar Augusto RamosZilberman, EduardoBerriel, Tiago CoutoFerreira, Pedro Cavalcanti Gomes2016-05-09T12:56:21Z2016-05-09T12:56:21Z2016-01-13GOMES, Diego Braz Pereira. Essays on health care reform, wealth inequality, and demography. Tese (Doutorado em Economia) - Escola de Pós-Graduação em Economia, Fundação Getúlio Vargas - FGV, Rio de Janeiro, 2016.https://hdl.handle.net/10438/16498This thesis contains three chapters. The first chapter uses a general equilibrium framework to simulate and compare the long run effects of the Patient Protection and Affordable Care Act (PPACA) and of health care costs reduction policies on macroeconomic variables, government budget, and welfare of individuals. We found that all policies were able to reduce uninsured population, with the PPACA being more effective than cost reductions. The PPACA increased public deficit mainly due to the Medicaid expansion, forcing tax hikes. On the other hand, cost reductions alleviated the fiscal burden of public insurance, reducing public deficit and taxes. Regarding welfare effects, the PPACA as a whole and cost reductions are welfare improving. High welfare gains would be achieved if the U.S. medical costs followed the same trend of OECD countries. Besides, feasible cost reductions are more welfare improving than most of the PPACA components, proving to be a good alternative. The second chapter documents that life cycle general equilibrium models with heterogeneous agents have a very hard time reproducing the American wealth distribution. A common assumption made in this literature is that all young adults enter the economy with no initial assets. In this chapter, we relax this assumption – not supported by the data – and evaluate the ability of an otherwise standard life cycle model to account for the U.S. wealth inequality. The new feature of the model is that agents enter the economy with assets drawn from an initial distribution of assets. We found that heterogeneity with respect to initial wealth is key for this class of models to replicate the data. According to our results, American inequality can be explained almost entirely by the fact that some individuals are lucky enough to be born into wealth, while others are born with few or no assets. The third chapter documents that a common assumption adopted in life cycle general equilibrium models is that the population is stable at steady state, that is, its relative age distribution becomes constant over time. An open question is whether the demographic assumptions commonly adopted in these models in fact imply that the population becomes stable. In this chapter we prove the existence of a stable population in a demographic environment where both the age-specific mortality rates and the population growth rate are constant over time, the setup commonly adopted in life cycle general equilibrium models. Hence, the stability of the population do not need to be taken as assumption in these models.Esta tese contém três capítulos. O primeiro capítulo usa um modelo de equilíbrio geral para simular e comparar os efeitos de longo prazo do Patient Protection and Affordable Care Act (PPACA) e de reduções de custos de saúde sobre variáveis macroeconômicas, orçamento do governo e bem-estar dos indivíduos. Nós encontramos que todas as políticas foram capazes de reduzir a população sem seguro, com o PPACA sendo mais eficaz do que reduções de custos. O PPACA aumentou o déficit público, principalmente devido à expansão do Medicaid, forçando aumento de impostos. Por outro lado, as reduções de custos aliviaram os encargos fiscais com seguro público, reduzindo o déficit público e impostos. Com relação aos efeitos de bem-estar, o PPACA como um todo e as reduções de custos melhoram o bem-estar dos indivíduos. Elevados ganhos de bem-estar seriam alcançados se os custos médicos norte-americanos seguissem a mesma tendência dos países da OCDE. Além disso, reduções de custos melhoram mais o bem-estar do que a maioria dos componentes do PPACA, provando ser uma boa alternativa. O segundo capítulo documenta que modelos de equilíbrio geral com ciclo de vida e agentes heterogêneos possuem muita dificuldade em reproduzir a distribuição de riqueza Americana. Uma hipótese comum feita nesta literatura é que todos os jovens adultos entram na economia sem ativos iniciais. Neste capítulo, nós relaxamos essa hipótese – não suportada pelos dados – e avaliamos a capacidade de um modelo de ciclo de vida padrão em explicar a desigualdade de riqueza dos EUA. A nova característica do modelo é que os agentes entram na economia com ativos sorteados de uma distribuição inicial de ativos. Nós encontramos que a heterogeneidade em relação à riqueza inicial é chave para esta classe de modelos replicar os dados. De acordo com nossos resultados, a desigualdade Americana pode ser explicada quase que inteiramente pelo fato de que alguns indivíduos têm sorte de nascer com riqueza, enquanto outros nascem com pouco ou nenhum ativo. O terceiro capítulo documenta que uma hipótese comum adotada em modelos de equilíbrio geral com ciclo de vida é de que a população é estável no estado estacionário, ou seja, sua distribuição relativa de idades se torna constante ao longo do tempo. Uma questão em aberto é se as hipóteses demográficas comumente adotadas nesses modelos de fato implicam que a população se torna estável. Neste capítulo nós provamos a existência de uma população estável em um ambiente demográfico onde tanto as taxas de mortalidade por idade e a taxa de crescimento da população são constantes ao longo do tempo, a configuração comumente adotada em modelos de equilíbrio geral com ciclo de vida. Portanto, a estabilidade da população não precisa ser tomada como hipótese nestes modelos.engHealth care reformHealth care cost reductionsInitial wealthLife cycleGeneral equilibriumHeterogeneous agentsDemographyReforma do sistema de saúdeReduções de custos de saúdeDesigualdade de riquezaRiqueza inicialCiclo de vidaEquilíbrio geralAgentes heterogêneosDemografiaPopulação estávelWealth inequalityStable populationEconomiaEquilíbrio econômicoReforma do sistema de saúdeSaúde pública - CustosRenda - DistribuiçãoBem-estar econômicoDemografiaModelo de população estávelEssays on health care reform, wealth inequality, and demographyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional do FGV (FGV Repositório Digital)instname:Fundação Getulio Vargas (FGV)instacron:FGVORIGINALThesis_Diego Braz Pereira Gomes.pdfThesis_Diego Braz Pereira 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InstitucionalPRIhttp://bibliotecadigital.fgv.br/dspace-oai/requestopendoar:39742024-06-10T15:43:20Repositório Institucional do FGV (FGV Repositório Digital) - Fundação Getulio Vargas 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|
dc.title.eng.fl_str_mv |
Essays on health care reform, wealth inequality, and demography |
title |
Essays on health care reform, wealth inequality, and demography |
spellingShingle |
Essays on health care reform, wealth inequality, and demography Gomes, Diego Braz Pereira Health care reform Health care cost reductions Initial wealth Life cycle General equilibrium Heterogeneous agents Demography Reforma do sistema de saúde Reduções de custos de saúde Desigualdade de riqueza Riqueza inicial Ciclo de vida Equilíbrio geral Agentes heterogêneos Demografia População estável Wealth inequality Stable population Economia Equilíbrio econômico Reforma do sistema de saúde Saúde pública - Custos Renda - Distribuição Bem-estar econômico Demografia Modelo de população estável |
title_short |
Essays on health care reform, wealth inequality, and demography |
title_full |
Essays on health care reform, wealth inequality, and demography |
title_fullStr |
Essays on health care reform, wealth inequality, and demography |
title_full_unstemmed |
Essays on health care reform, wealth inequality, and demography |
title_sort |
Essays on health care reform, wealth inequality, and demography |
author |
Gomes, Diego Braz Pereira |
author_facet |
Gomes, Diego Braz Pereira |
author_role |
author |
dc.contributor.unidadefgv.por.fl_str_mv |
Escolas::EPGE |
dc.contributor.member.none.fl_str_mv |
Costa, Carlos Eugênio Ellery Lustosa da Santos, Cézar Augusto Ramos Zilberman, Eduardo Berriel, Tiago Couto |
dc.contributor.author.fl_str_mv |
Gomes, Diego Braz Pereira |
dc.contributor.advisor1.fl_str_mv |
Ferreira, Pedro Cavalcanti Gomes |
contributor_str_mv |
Ferreira, Pedro Cavalcanti Gomes |
dc.subject.por.fl_str_mv |
Health care reform Health care cost reductions Initial wealth Life cycle General equilibrium Heterogeneous agents Demography Reforma do sistema de saúde Reduções de custos de saúde Desigualdade de riqueza Riqueza inicial Ciclo de vida Equilíbrio geral Agentes heterogêneos Demografia População estável |
topic |
Health care reform Health care cost reductions Initial wealth Life cycle General equilibrium Heterogeneous agents Demography Reforma do sistema de saúde Reduções de custos de saúde Desigualdade de riqueza Riqueza inicial Ciclo de vida Equilíbrio geral Agentes heterogêneos Demografia População estável Wealth inequality Stable population Economia Equilíbrio econômico Reforma do sistema de saúde Saúde pública - Custos Renda - Distribuição Bem-estar econômico Demografia Modelo de população estável |
dc.subject.eng.fl_str_mv |
Wealth inequality Stable population |
dc.subject.area.por.fl_str_mv |
Economia |
dc.subject.bibliodata.por.fl_str_mv |
Equilíbrio econômico Reforma do sistema de saúde Saúde pública - Custos Renda - Distribuição Bem-estar econômico Demografia Modelo de população estável |
description |
This thesis contains three chapters. The first chapter uses a general equilibrium framework to simulate and compare the long run effects of the Patient Protection and Affordable Care Act (PPACA) and of health care costs reduction policies on macroeconomic variables, government budget, and welfare of individuals. We found that all policies were able to reduce uninsured population, with the PPACA being more effective than cost reductions. The PPACA increased public deficit mainly due to the Medicaid expansion, forcing tax hikes. On the other hand, cost reductions alleviated the fiscal burden of public insurance, reducing public deficit and taxes. Regarding welfare effects, the PPACA as a whole and cost reductions are welfare improving. High welfare gains would be achieved if the U.S. medical costs followed the same trend of OECD countries. Besides, feasible cost reductions are more welfare improving than most of the PPACA components, proving to be a good alternative. The second chapter documents that life cycle general equilibrium models with heterogeneous agents have a very hard time reproducing the American wealth distribution. A common assumption made in this literature is that all young adults enter the economy with no initial assets. In this chapter, we relax this assumption – not supported by the data – and evaluate the ability of an otherwise standard life cycle model to account for the U.S. wealth inequality. The new feature of the model is that agents enter the economy with assets drawn from an initial distribution of assets. We found that heterogeneity with respect to initial wealth is key for this class of models to replicate the data. According to our results, American inequality can be explained almost entirely by the fact that some individuals are lucky enough to be born into wealth, while others are born with few or no assets. The third chapter documents that a common assumption adopted in life cycle general equilibrium models is that the population is stable at steady state, that is, its relative age distribution becomes constant over time. An open question is whether the demographic assumptions commonly adopted in these models in fact imply that the population becomes stable. In this chapter we prove the existence of a stable population in a demographic environment where both the age-specific mortality rates and the population growth rate are constant over time, the setup commonly adopted in life cycle general equilibrium models. Hence, the stability of the population do not need to be taken as assumption in these models. |
publishDate |
2016 |
dc.date.accessioned.fl_str_mv |
2016-05-09T12:56:21Z |
dc.date.available.fl_str_mv |
2016-05-09T12:56:21Z |
dc.date.issued.fl_str_mv |
2016-01-13 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
GOMES, Diego Braz Pereira. Essays on health care reform, wealth inequality, and demography. Tese (Doutorado em Economia) - Escola de Pós-Graduação em Economia, Fundação Getúlio Vargas - FGV, Rio de Janeiro, 2016. |
dc.identifier.uri.fl_str_mv |
https://hdl.handle.net/10438/16498 |
identifier_str_mv |
GOMES, Diego Braz Pereira. Essays on health care reform, wealth inequality, and demography. Tese (Doutorado em Economia) - Escola de Pós-Graduação em Economia, Fundação Getúlio Vargas - FGV, Rio de Janeiro, 2016. |
url |
https://hdl.handle.net/10438/16498 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional do FGV (FGV Repositório Digital) instname:Fundação Getulio Vargas (FGV) instacron:FGV |
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Fundação Getulio Vargas (FGV) |
instacron_str |
FGV |
institution |
FGV |
reponame_str |
Repositório Institucional do FGV (FGV Repositório Digital) |
collection |
Repositório Institucional do FGV (FGV Repositório Digital) |
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