This paper examines the causes and consequences of reductions in cardiovascular disease mortality, and in particular heart attack mortality, over the past several decades. Analysis of data from Medicare and review of the clinical literature indicate that a large share of the recent decline in...

There is little empirical evidence to explain why disability declined among the elderly over the past 20 years. In this paper, we explore the role of improved medical care for cardiovascular disease on health status improvements over time. We show that the incidence of cardiovascular disease...

We use data across states to examine the relation between HMO enrollment and medical spending. We find that increased managed care enrollment significantly reduces hospital cost growth. While some of this effect is offset by increased spending on physicians, we generally find a significant...

This paper examines consolidation in the Massachusetts hospital market. We find that consolidation is driven primarily by a large decline in the demand for hospital beds, resulting from increased enrollment in managed care and technological changes. The drive to consolidate appears through three...

This paper reviews the public sector role in the provision of health care. A first role of the government is to use tax policy to correct externalities associated with individual behaviors. Estimates suggest that the external effects of many `sins' such as alcohol consumption are greater than...

Mortality rates in the US fell more rapidly during the late 19th and early 20th Centuries than any other period in American history. This decline coincided with an epidemiological transition and the disappearance of a mortality "penalty" associated with living in urban areas. There is little...

This paper examines the sources of expenditure growth in heart attack treatment. We first show that essentially all of cost growth is a result of the diffusion of particular intensive technologies; the prices paid for a given level of technology have been constant or falling over time. We then...

We address long-standing problems in measuring health care prices by estimating two medical care price indices. The first, a Service Price Index, prices specific medical services, as does the current CPI. The second, a Cost of Living Index, measures the net valuation of treating a health...

This paper explores the relationship between the demographic characteristics of a community and the quantities of goods and services provided by its government We consider three models of public spending: a traditional "selfish" public choice model in which individuals care only about...

Recent litigation against major tobacco companies culminated in a Master Settlement Agreement' (MSA) under which the participating companies agreed to compensate most states for Medicaid expenses. We outline the terms of the settlement and analyze whether it was a move toward economic efficiency...