Nicolas R. Ziebarth

THE EFFECTS OF EXPANDING THE GENEROSITY OF THE STATUTORY SICKNESS INSURANCE SYSTEM

This article evaluates an expansion of employer-mandated sick leave from 80 to 100 percent of forgone gross wages in Germany. We employ and compare parametric difference-in-difference (DID), matching DID, and mixed approaches. Overall workplace attendance decreased by at least 10 percent or 1 day per worker per year. We show that taking partial compliance into account increases coefficient estimates. Further, heterogeneity in response behavior was of great importance. There is no evidence that the increase in sick leave improved employee health, a finding that supports a shirking explanation. Finally, we provide evidence on potential labor market adjustments to the reform.

Measurement of health, health inequality, and reporting heterogeneity

Using representative survey data of the German Socio-Economic Panel Study (SOEP) for 2006, we show that the magnitude of health inequality measures like the concentration index (CI) depends crucially on the underlying health measure. The highest degree of inequality is found when dichotomized subjective health measures like health satisfaction or self-assessed health (SAH) are employed. With the use of SF12, a generic health measure, the inequality indicator is reduced by a factor of ten. We show that the process of dichotomizing variables leads to such huge differences. Cardinalizing SAH by means of the SF12 leads to similar results to those with the pure SF12 measure. Employing generic health measures used with other populations like the Canadian HUI-III or the Finnish 15D to cardinalize SAH has a significant impact on the degree of inequality measured. Finally, by contrasting the physical health component of the SF12 to the unambiguously objective grip strength measure, we provide evidence of the presence of income-related reporting heterogeneity in generic health measures.

Long-Term Absenteeism and Moral Hazard - Evidence from a Natural Experiment

This paper shows that long-term sick employees are unlikely to be very responsive to moderate monetary labor supply incentives. The paper, theoretically and empirically, evaluates the labor supply effects of cuts in statutory sick pay levels on long-term absenteeism in Germany. Cutting sick pay did not significantly reduce the average incidence and duration of sick leave periods longer than six weeks. A simple theoretical model confirms the empirical findings under the assumption that the long-term sick are seriously sick. Thus, moral hazard seems to be less of an issue in the upper tail of the sickness spell distribution. However, the results show heterogeneity in the effects and significant duration decreases for certain subsamples.

Estimating Price Elasticities of Convalescent Care Programmes

This study is the first to estimate price elasticities of demand for convalescent care programmes. In 1997, the German legislature more than doubled the daily co-payments for the publicly insured from €6 to €13. The measure caused the overall demand for convalescent care treatments to fall by 20 to 25%. I estimate the price elasticity for medical rehabilitation programmes aimed at preventing work disability to be about - 0.3, whereas the elasticity for medical rehabilitation programmes for recovery from accidents at work lies around - 0.5. The demand for preventive treatment at health spas is elastic and less than - 1. Copyright

In Vino Pecunia? The Association between Beverage-Specific Drinking Behavior and Wages

The positive association between moderate alcohol consumption and wages is well documented in the economic literature. Positive health effects as well as networking mechanisms serve as explanations for the “alcohol–income puzzle.” Using individual-based microdata from the SOEP for 2006, we confirm that this relationship exists for Germany as well. More importantly, we shed light on the alcohol–income puzzle by analyzing, for the first time, the association between beverage-specific drinking behavior and wages. In our analysis, we disentangle the general wage effect of drinking into diverse effects for different types of drinkers. Mincerian estimates reveal significant and positive relationships between wine drinkers and wages as well as between multiple beverage drinkers and wages. When splitting the sample into age groups, the “drinking gain” disappears for employees under the age of 35 and increases in size and significance for higher age groups. We also find a “beer gain” for the oldest age group and male residents of rural areas as well as a “cocktail gain” for residents of urban areas. Several explanations for our empirical results are discussed in view of the likelihood that the alcohol–income puzzle is a multicausal phenomenon.

How natural disasters can affect environmental concerns, risk aversion, and even politics: evidence from Fukushima and three European countries

We study the impact of the Fukushima disaster on environmental concerns, well-being, risk aversion, and political preferences in Germany, Switzerland, and the UK. In these countries, overall life satisfaction did not significantly decrease, but the disaster significantly increased environmental concerns among Germans. One underlying mechanism likely operated through the perceived risk of a similar meltdown of domestic reactors. After Fukushima, more Germans considered themselves as “very risk averse.” However, drastic German policy action shut down the oldest reactors, implemented the phaseout of the remaining ones, and proclaimed the transition to renewables. This shift in energy policy contributed to the subsequent decrease in environmental concerns, particularly among women, Green party supporters, and people living in close distance to the oldest reactors. In Germany, political support for the Greens increased significantly, whereas in Switzerland and the UK, this increase was limited to people living close to reactors.

Does Price Framing Affect the Consumer Price Sensitivity of Health Plan Choice

This paper provides field evidence on how price framing affects consumers’ decision to switch health plans. In 2009 German federal regulation required insurers to express premium differences between standardized health plans in absolute euro values relative to a federal reference price, rather than in percentage point payroll tax differences. Representative individual-level panel data and aggregated health plan level panel data on the universe of health plans show that the reform strongly increased enrollees’ willingness to switch plans, with demand elasticities increasing fourfold. The salience of premium differences and the default premium are obviously key driving forces in the decision to switch insurers.

Welfare-related health inequality: does the choice of measure matter?

Using representative microdata from the German Socio-Economic Panel Study (SOEP), we show that the welfare measure choice has a substantial impact on the degree of welfare-related health inequality. To assess the sensitivity of welfare-related health inequality measures, we combine a unique set of income and wealth measures with different subjective, cardinalized, and (quasi-)objective health measures. The influence of the welfare measure is more pronounced when using subjective health measures than when using (quasi-)objective health measures.

Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care

This study empirically evaluates the effectiveness of different health care cost containment measures. The measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for rehabilitation care. Of the analyzed measures, doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in utilization of about