期刊-NBER美国国民经济研究局-Spring1993_35页_771kb

MBER Reporter Summary - Health Economics

Core Content

The Program Report on Health Economics from the National Bureau of Economic Research (NBER) in Spring 1993 highlights the research on the determinants and consequences of unhealthy behaviors such as excessive alcohol use, cigarette smoking, and illegal drug use. The report emphasizes the distinction between health as an output and medical care as an input in the production of health.

Main Focus Areas

1. Alcohol Control Policies and Motor Vehicle Fatalities

   • Federal, state, and local governments have implemented policies to reduce alcohol-related motor vehicle fatalities.
   • The Federal Uniform Drinking Age Act of 1984 raised the minimum legal drinking age to 21, resulting in significant reductions in youth fatalities.
   • Studies show that increasing alcohol taxes can effectively reduce youth drinking and related fatalities. Indexing the federal excise tax on beer to inflation since 1951 would have led to substantial declines in youth drinking.
   • Real price declines of alcoholic beverages over time, due to stable taxation, have contributed to increased consumption, despite efforts to curb it.

2. Empirical Analysis of Cigarette and Alcohol Addiction

   • Research challenges the conventional view that addictions are insensitive to price.
   • The concept of rational addiction is explored, where current consumption is influenced by both past and future price expectations.
   • Long-run price elasticity for cigarettes and liver cirrhosis is found to be more significant than short-run effects.

3. Other Alcohol Studies

   • Alcohol advertising has modest effects on consumption, and bans may have more substantial impacts.
   • Moderate alcohol consumption is associated with lower coronary heart disease mortality, but this effect disappears when individuals with pre-existing heart conditions are excluded.
   • Maternal substance abuse is a major factor in the rise of low birthweight infants in New York City, with a significant portion of the increase attributed to drug use.

4. Determinants and Consequences of Illegal Drug Use

   • Five new projects examine the causes and effects of illegal drug use.
   • Research explores the impact of fines and penalties on crime and drug use.
   • Cost-benefit analysis of prenatal substance abuse treatment programs is conducted.
   • Neonatal care costs related to maternal drug use are analyzed using hospital data.
   • Drug-related deaths in New York City are used as a proxy to assess drug use impacts on crime.

Key Findings

• Alcohol taxation is an effective policy tool to reduce youth drinking and motor vehicle fatalities.
• Indexing beer taxes to inflation could lead to significant declines in youth alcohol consumption.
• Raising the legal drinking age to 21 has a smaller effect compared to tax increases.
• Rational addiction is supported by empirical evidence, showing that price changes affect current consumption behavior.
• Alcohol advertising has limited impact, but bans in some OECD countries are associated with lower consumption and fatalities.
• Maternal drug use is a major cause of low birthweight infants, which has serious long-term health and economic consequences.
• Illegal drug use influences crime rates and motor vehicle mortality, with research focusing on the economic and social impacts.

Tax Policy Research Summary

Main Research Areas

• Federal Tax Deductibility and State and Local Taxes

  • The Tax Reform Act of 1986 (TRA86) eliminated the deduction for state and local taxes, which was expected to increase federal tax receipts.
  • However, research suggests that the elimination of deductions leads to a shift in tax preferences, and the overall level of state and local spending is not significantly affected.
  • The NBER TAXSIM model was used to analyze tax price effects and show that changes in deductibility have large effects on the distribution of tax instruments.

• Tax Incidence

  • The lifetime incidence of state and local taxes is more progressive than the annual incidence.
  • A value-added tax (VAT) that excludes necessities can be moderately progressive over the life cycle, contrasting with its regressive nature in an annual framework.

• Energy Efficiency and Tax Incentives

  • Studies suggest that tax incentives for energy conservation have had little effect on investment in energy-efficient capital.
  • The lack of response is attributed to the endogeneity of state tax programs and the irreversibility and risk of such investments.
  • Models from Dixit and Pindyck help explain the high discount rates observed in energy-efficient investment studies.

NBER Directors and Profiles

Directors at Large

• John Herron Biggs
• Andrew Brimmer
• Carl F. Christ
• George T. Conklin, Jr.
• Don R. Conlan
• Kathleen B. Cooper
• Jean A. Crockett
• George C. Eads
• Martin Feldstein
• George Hatsopoulos
• Lawrence R. Klein
• Franklin A. Lindsay
• Paul W. McCracken
• Leo Melamed
• Robert T. Parry
• Peter G. Peterson
• Robert V. Roosa
• Richard N. Rosett
• Bert Seidman
• Eli Shapiro
• James Smith
• Donald S. Wasserman

Directors by University Appointment

• Jagdish W. Bhagwati, Columbia
• William C. Brainard, Yale
• Glen G. Cain, Wisconsin
• Franklin Fisher, MIT
• Saul H. Hymans, Michigan
• Marjorie B. McElroy, Duke
• James L. Pierce, Berkeley
• Andrew Postlewaite, Pennsylvania
• Nathan Rosenberg, Stanford
• Harold T. Shapiro, Princeton
• Craig Swan, Minnesota
• Michael Yoshino, Harvard
• Arnold Zellner, Chicago

Directors by Appointment of Other Organizations

• Marcel Boyer, Canadian Economics Association
• Rueben C. Buse, American Agricultural Economics Association
• Richard A. Easterlin, Economic History Association
• Gail Fosler, The Conference Board
• A. Ronald Gallant, American Statistical Association
• Robert S. Hamada, American Finance Association
• Charles Lave, American Economic Association
• Rudolph A. Oswald, AFL-CIO
• Dean P. Phypers, Committee for Economic Development
• James F. Smith, National Association of Business Economists
• Charles A. Walworth, AICPA

Key Researchers

• Michael Grossman: Director of the Program in Health Economics, focuses on the effects of alcohol and drug use on health outcomes.
• Frank J. Chaloupka: Collaborates on studies of youth alcohol use and illegal drug demand.
• Henry Saffer: Analyzes the impact of alcohol taxes and drug-related policies.
• Gilbert E. Metcalf: Researches tax policy, particularly in a federal system, and its effects on government behavior and tax incidence.

Additional Information

• Contributions to the NBER are tax-deductible.
• The NBER Reporter is not copyrighted and can be freely reproduced with proper attribution.
• The NBER Public Information Department should be informed of any reproductions.
• The Reporter is issued for informational purposes and not reviewed by the Board of Directors.