Browsing by Author "Tran, Chung"
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Item Aging and health financing in the U.S.: a general equilibrium analysis(Towson University. Department of Economics, 2016) Jung, Juergen; Tran, Chung; Chambers, Matthew; Towson University. Department of EconomicsWe quantify the effects of population aging on the U.S. healthcare system. Our analysis is based on a stochastic general equilibrium overlapping generations model of endogenous health accumulation calibrated to match pre-2010 U.S. data. We find that population aging not only leads to large increases in medical spending but also a large shift in the relative size of private vs. public insurance. Without the Affordable Care Act (ACA), aging by itself leads to a 40 percent increase in health expenditures by 2060 and a 9.6 percent increase in GDP which is mainly driven by the increase of the fraction of older higher-risk individuals in the economy as well as behavioral responses to aging and the subsequent expansion of the healthcare sector. Aging increases the premium in group-based health insurance (GHI) markets and enrollment in GHI decreases, while the individual-based health insurance (IHI) market, Medicaid and Medicare expand significantly. The size of Medicare will double by 2060 as the elderly dependency ratio increases. Additional funds equivalent to roughly 2.8 percent of GDP are required to finance Medicare and Medicaid. The introduction of the ACA increases the fraction of insured workers to almost 100 percent by 2060, compared to 82 percent without the ACA. This increase is driven by the stabilization of GHI markets and the further expansions of Medicaid and the IHI market. The ACA mitigates the increase of healthcare costs by reducing the number of the uninsured who pay the highest market price for healthcare services. Overall, the ACA adds to the fiscal cost of population aging mainly via the Medicaid expansion. Our findings demonstrate the importance of accounting for behavioral responses, structural changes in the healthcare sector and general equilibrium adjustments when assessing the economy-wide effects of aging.Item The extension of social security coverage in developing countries(Towson University. Department of Economics, 2011-11-08) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe study the dynamic general equilibrium effects of introducing a social pension pro- gram to elderly informal sector workers in developing countries who lack formal risk sharing mechanisms against income and longevity risk. To this end, we formulate a stochastic dynamic general equilibrium model that incorporates defining features of developing countries: a large informal sector, private transfers as an informal safety net, and a non-universal social security system. We find that the extension of retirement benefits to informal sector workers results in efficiency losses due to adverse effects on capital accumulation and the allocation of resources across formal and informal sectors. Despite these losses recipients of social pensions experience welfare gains as the positive insurance effects attributed to the extension of a social insurance system dominate. The welfare gains crucially depend on the skill distribution, private intra-family transfers and the specific tax used to finance the expansion.Item Fiscal austerity measures: spending cuts vs. tax increases(Towson University. Department of Economics, 2013-08-19) Glomm, Gerhard; Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe formulate an overlapping generations model with skill heterogeneity and productive and non-productive government programs to study the macroeconomic and intergenera- tional welfare effects caused by risk premium shocks and government debt reductions. We demonstrate that in a small open economy with a high level of debt-to-GDP ratio a small increase in the risk premium leads to substantial output contraction and negative welfare ef- fects. Next, we quantify the effects of reducing the debt-to-GDP ratio using a wide range of fiscal austerity measures. These reforms result in trade-offs between short-run contractions and long-run expansions in aggregate output. In addition, the spending-based austerity reform is dominated by the tax-based reform in terms of income in the short run, but be- comes dominant in the long run. The welfare effects vary significantly across generations, depending on fiscal austerity measures, skills and working sector. The current old and middle age generations experience welfare losses while current young workers and future generations are beneficiaries of the reforms. A mixed reform results in the largest welfare effects.Item Health care financing over the life cycle, universal medical vouchers and welfare(Towson University. Department of Economics, 2010-01) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsIn this paper we develop a general equilibrium overlapping generations (OLG) model with health shocks to analyze the life-cycle pattern of insurance choice and health care spending. We use data from the Medical Expenditure Panel Survey (MEPS) and show that our model is able to match the life-cycle trends of insurance take up ratios and average medical expenditures in the U.S. We then demonstrate how this model can be used to conduct health care policy analysis by evaluating the macroeconomic effects of a counter factual health care reform using a system of universal health insurance vouchers. Our results suggest that health insurance vouchers are able to extend insurance coverage to the entire population but they also increase aggregate spending on health. More importantly, we find that the positive insurance effect (efficient risk pooling) dominates the negative incentive effect (tax distortions and moral hazard) which results in significant welfare gains for all generations when a payroll tax is used to finance the voucher program. In addition, our results suggest that the choice of tax financing instrument and accounting for general equilibrium price adjustments are critical in determining the performance of the voucher program.Item The macroeconomics of heath savings accounts(Towson University. Department of Economics, 2010) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe analyze whether the introduction of Health Savings Accounts (HSAs), which is a health insurance reform coupled with a capital tax reform, can reduce health care expenditures in the United States, while simultaneously increasing the fraction of insured individuals. Unlike previous studies on HSAs, our analysis relies on a general equilibrium framework and therefore fully accounts for feedback effects from general equilibrium price adjustments. Our results from numerical simulations indicate that the introduction of HSAs increases the percentage of the working age population with health insurance in the long run but fails to curtail spending on health care. These results depend critically on the interaction of general equilibrium effects and the annual contribution limits to HSAs. Finally, the long-run tax revenue loss due to the introduction of HSAs is substantial and can amount to up to 5 percent of GDP.Item Market inefficiency, insurance mandate and welfare: U.S. health care reform 2010(Towson University. Department of Economics, 2014-09) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe quantify the effects of the Affordable Care Act (ACA) using a stochastic general equilibrium overlapping generations model with endogenous health capital accumulation calibrated to match U.S. data on health spending and insurance take-up over the lifecycle. We find that the introduction of an insurance mandate and the expansion of Medicaid which are at the core of the ACA increase the insurance take-up rate of workers to almost universal coverage but decrease capital accumulation, labor supply and aggregate output. Penalties for not having insurance as well as subsidies to assist low income individuals’ purchase of insurance via health insurance market places do reduce the adverse selection problem in private health insurance markets and do counteract the crowding-out effect of the Medicaid expansion. The redistributional measures embedded in the ACA result in welfare gains for low income individuals in poor health and welfare losses for high income individuals in good health. The overall welfare effect depends on the size of the ex-post moral hazard effect, tax distortions and general equilibrium price adjustments.Item Medical consumption over the life cycle: facts from a U.S. medical expenditure panel survey(Towson University. Department of Economics, 2010) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe investigate the association between age and medical spending in the U.S. using data from the Medical Expenditure Panel Survey (MEPS). We estimate a partial linear seminonparametric model and construct “pure” life-cycle profiles of health spending simultaneously controlling for time effects (i.e. institutional changes and business cycles effects) and cohort effects (i.e. generation specific conditions). We find that time and cohort effects introduce a significant estimation bias into predictions of health expenditures per age group, especially for individuals older than 60 years. The estimation biases introduced by cohort effects increase monotonically with age while time effects are non-monotone. Overall, cohort effect biases dominate time effect biases in magnitude for high age groups.Item Optimal progressive income taxation in a Bewley-Grossman framework(Towson University. Department of Economics, 2017-03) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe study the optimal income tax progressivity in a Bewley-Grossman model where individuals are exposed to income and health risks over the lifecycle. Our results, based on a calibration for the US economy, indicate that the presence of health shocks requires the government to set higher optimal levels of tax progressivity in order to provide more social insurance for unhealthy low income individuals who have limited access to health insurance. The optimal progressive income tax system includes a tax break for income below $36, 400 and high marginal tax rates of over 50 percent for income earners above $200, 000. The tax progressivity (Suits) index—a Gini coefficient for income tax contributions by income—of the optimal tax system is around 0.53, compared to 0.17 in the benchmark tax system. Welfare gains from switching to the optimal tax system amount to over 5 percent of compensating lifetime consumption. The presence of health risk amplifies the social insurance role of the progressive income tax system. The optimal tax system in our model with health risk is more progressive than the optimal tax systems in models without health risk (e.g., Conesa and Krueger (2006) and Heathcote, Storesletten and Violante (2017)). When health risk is removed from the model, the optimal tax system becomes less progressive and thus more similar to the optimal progressivity levels reported in the literature. In addition, the optimal level of tax progressivity is strongly affected by the design of the health insurance system.Item Social health insurance: a quantitative exploration(Towson University. Department of Economics, 2016-06) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsWe quantify the welfare implications of three alternative approaches to providing health insurance: (i) a US-style mix of private and public health insurance, (ii) compulsory univer- sal public health insurance (UPHI) and (iii) private health insurance for workers combined with government subsidies and price regulation. We use a Bewley-Grossman lifecycle model calibrated to match the lifecycle structure of earnings and health risks in the US. For all three systems we find that welfare gains triggered by a combination of improvements in risk sharing and wealth redistribution dominate welfare losses caused by tax distortions and ex-post moral hazard effects. Overall, the UPHI system outperforms the other two systems in terms of welfare gains if the coinsurance rate is properly designed. A direct comparison between the US system to a well-designed UPHI system reveals that large welfare gains are possible in the long-run. However, such a radical reform faces political impediments due to opposing welfare effects across different income groups.Item Transfers and labor market behavior of the elderly in developing countries: theory and evidence from Vietnam(Towson University. Department of Economics, 2009-08-28) Jung, Juergen; Tran, Chung; Towson University. Department of EconomicsIn this paper we argue that the strategic interaction between the labor supply decision of the elderly and private transfers from their children lowers the opportunity cost of leisure of the elderly. This in turn magnifies the crowding-out effect of public pensions on the labor supply of the elderly. We show that this mechanism has implications for evaluating the crowding-out effect of public pensions in developing countries. That is, a misspecified econometric model that does not control for the endogeneity of private transfers leads to a biased estimate of the crowding-out effect of public pensions. Using data from a household survey in Vietnam we find that the effect of public pensions on the probability of retirement is 2.5 times larger when explicitly accounting for the interaction between private transfers and the labor supply decision of elderly individuals.