Adam Gailey

The value of medical and pharmaceutical interventions for reducing obesity

This paper attempts to quantify the social, private, and public-finance values of reducing obesity through pharmaceutical and medical interventions. We find that the total social value of bariatric surgery is large for treated patients, with incremental social cost-effectiveness ratios typically under

Differences in health between Americans and Western Europeans: Effects on longevity and public finance

10,000 per life-year saved. On the other hand, pharmaceutical interventions against obesity yield much less social value with incremental social cost-effectiveness ratios around

Understanding the Economic Consequences of Shifting Trends in Population Health

50,000. Our approach accounts for: competing risks to life expectancy; health care costs; and a variety of non-medical economic consequences (pensions, disability insurance, taxes, and earnings), which account for 20% of the total social cost of these treatments. On balance, bariatric surgery generates substantial private value for those treated, in the form of health and other economic consequences. The net public fiscal effects are modest, primarily because the size of the population eligible for treatment is small. The net social effect is large once improvements in life expectancy are taken into account.

International Differences in Longevity and Health and Their Economic Consequences

In 1975, 50-year-old Americans could expect to live slightly longer than most of their Western European counterparts. By 2005, American life expectancy had fallen behind that of most Western European countries. We find that this growing longevity gap is primarily due to real declines in the health of near-elderly Americans, relative to their Western European peers. We use a microsimulation approach to project what US longevity would look like, if US health trends approximated those in Western Europe. The model implies that differences in health can explain most of the growing gap in remaining life expectancy. In addition, we quantify the public finance consequences of this deterioration in health. The model predicts that gradually moving American cohorts to the health status enjoyed by Western Europeans could save up to

Patents, innovation, and the welfare effects of Medicare Part D

1.1 trillion in discounted total health expenditures from 2004 to 2050.

The Fiscal Consequences of Trends in Population Health

The public economic burden of shifting trends in population health remains uncertain. Sustained increases in obesity, diabetes, and other diseases could reduce life expectancy - with a concomitant decrease in the public-sectors annuity burden - but these savings may be offset by worsening functional status, which increases health care spending, reduces labor supply, and increases public assistance. Using a microsimulation approach, we quantify the competing public-finance consequences of shifting trends in population health for medical care costs, labor supply, earnings, wealth, tax revenues, and government expenditures (including Social Security and income assistance). Together, the reduction in smoking and the rise in obesity have increased net public-sector liabilities by

Workers' Compensation Reform and Return to Work

430bn, or approximately 4% of the current debt burden. Larger effects are observed for specific public programs: annual spending is 10% higher in the Medicaid program, and 7% higher for Medicare.

International Differences in Longevity and Health and their Economic Consequences

In 1975, 50 year-old Americans could expect to live slightly longer than their European counterparts. By 2005, American life expectancy at that age has diverged substantially compared to Europe. We find that this growing longevity gap is primarily the symptom of real declines in the health of near-elderly Americans, relative to their European peers. In particular, we use a microsimulation approach to project what US longevity would look like, if US health trends approximated those in Europe. We find that differences in health can explain most of the growing gap in remaining life expectancy. In addition, we quantify the public finance consequences of this deterioration in health. The model predicts that gradually moving American cohorts to the health status enjoyed by Europeans could save up to

California's Workers' Compensation Reform

1.1 trillion in discounted total health expenditures from 2004 to 2050.

The Value of Medican and Pharmaceutical Interventions for Reducing Obesity

PURPOSE To evaluate the efficiency consequences of the Medicare Part D program. METHODS We develop and empirically calibrate a simple theoretical model to examine the static and the dynamic welfare effects of Medicare Part D. FINDINGS We show that Medicare Part D can simultaneously reduce static deadweight loss from monopoly pricing of drugs and improve incentives for innovation. We estimate that even after excluding the insurance value of the program, the welfare gain of Medicare Part D roughly equals its social costs. The program generates