Essays in public and health economics

Minten, Thomas (2021) Essays in public and health economics. PhD thesis, London School of Economics and Political Science.

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Abstract

While citizens in rich countries have indisputably become healthier and richer on average, there is a general sense that this progress has not benefited everyone equally and that health and economic inequality has increased. This thesis contributes to the literature on the measurement and causes of such trends in inequalities by using newly available administrative data in the low countries Belgium and the Netherlands to document and analyze three separate dimensions of contemporary health and economic inequality. The first chapter analyzes the evolution of migrants' descendants' educational outcomes and incomes in the Netherlands, with a focus on second and third generations migrants from Morocco, Suriname and Turkey. While gaps between natives' and migrants' descendants remain large, gaps are generally smaller for later generations, and are overall decreasing. Moreover, using migrant-of-entry fixed effects, a positive effect of the length of stay of migrant families in the Netherlands on the test scores of migrants' children is established and continues after fifty years. I complement these findings with a discussion of migrants' mobility patterns and the role of intermarriage in economic integration. The second chapter concerns the choice quality of insurance contracts by individuals in the Netherlands. We study a specific attribute of the health insurance purchase decision all Dutch inhabitants make: the choice of the size of the deductible. We find that individual choice quality is strongly correlated with the education level and professional sector. Moreover, there is a strong correlation between the decision quality of an individual and those of his/her connections, as we find within-firm, location and family impacts on decision making. We document that such inequality in choice quality leads to substantial difierences in financial outcomes, and evaluate alternative policies. The third chapter analyzes the distributional pattern of mortality in Belgium during the first wave of the Covid-19 pandemic in 2020. Using population-wide administrative data, we find that there is a significant negative income gradient in excess mortality, with excess deaths in the bottom income decile more than twice as high as in the top income decile. However, compared to the inequality in mortality in normal times, the income gradient in all-cause mortality is only marginally steeper.

Item Type:	Thesis (PhD)
Additional Information:	© 2021 Thomas Minten
Library of Congress subject classification:	H Social Sciences > HC Economic History and Conditions R Medicine > RA Public aspects of medicine
Sets:	Departments > Economics
Supervisor:	Spinnewijn, Johannes
URI:	http://etheses.lse.ac.uk/id/eprint/4371

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