ESSAYS ON THE ECONOMICS OF HEALTH AND HOUSING POLICY

Holz, Nicole

doi:https://doi.org/10.21985/n2-3g6k-m683

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ESSAYS ON THE ECONOMICS OF HEALTH AND HOUSING POLICY

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This dissertation explores the economics of health and housing policies. In the first chapter, I discuss information disclosure policies in healthcare. Information disclosure programs can help consumers make better choices, but the consumers who respond the most to the information may not benefit the most or generate the most savings for firms designing the programs. I examine a disclosure program used by a private health insurer that highlights status of physicians based on two dimensions: quality and cost. Using a regression discontinuity design, I find that the higher physician status leads to 38\% more new patients for physicians with that status (when compared to physicians with the lower status), and that the disclosure program’s influence is stronger for younger patients. These young patients, however, may not benefit in terms of spending as much as other patients from being matched to higher-quality and lower physicians. Using a two-way fixed effects research design studying patients who switch physicians following physician exit (from retiring or moving), I find that switching to higher-quality and lower cost physicians leads to larger declines in spending for middle-aged patients than for younger adult patients, with no evidence of adverse effects in terms of preventable emergency room visits. Collectively, these results indicate that targeting disclosure programs to middle-aged patients can achieve greater cost savings than web-based ratings systems that are disproportionately used by younger patients. In the second chapter, I explore a question related to both health and housing: how rent control impact intimate partner violence (IPV). Policy advocates claim that one benefit of rent control may be decreased intimate partner violence. However, the theoretical effects of rent control on IPV are ambiguous. Rent control may lessen financial stressors within a relationship and decrease strain that leads to violence. However, it may make leaving the relationship more costly, shifting the bargaining power in the relationship and leading to more violence. My coauthor and I leverage the 1994 expansion of rent control in San Francisco as a natural experiment to study this question. This expansion created variation across zip codes in the number of rental units that were newly rent controlled. We exploit this variation in a continuous difference-in-difference design. We estimate an elasticity of -0.08 between the number of newly rent controlled units and assaults on women resulting in hospitalization. This effect translates to a nearly 10\% decrease in assaults on women for the average zip code. This relationship is not explained by changes in neighborhood composition or overall crime, consistent with the effects being driven by individual level changes in IPV. In the final chapter, I explore further consequences of rent control policies. Rent control policies seek to ensure affordable and stable housing for current tenants; however, they also increase the incentive for landlords to evict tenants since rents re-set when tenants leave. My coauthor and I exploit variation across zip codes in policy exposure to the 1994 rent control referendum in San Francisco to study the effects of rent control on eviction behavior. We find that for every 1,000 newly rent controlled units in a zip code, there were 12.05 additional eviction notices filed in that zip code and an addi- tional 4.6 wrongful eviction claims. These effects were concentrated in low income zip codes.

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