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Health Care Access, Costs, and Treatment Dynamics: Evidence from In Vitro Fertilization

Author

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  • Barton H. Hamilton
  • Emily Jungheim
  • Brian McManus
  • Juan Pantano

Abstract

We study public policies designed to improve access and reduce costs for In Vitro Fertilization (IVF). High out-of-pocket prices can deter potential patients from IVF, while active patients have an incentive to risk costly high-order pregnancies to improve their odds of treatment success. We analyze IVF's rich choice structure by estimating a dynamic model of patients' choices within and across treatments. Policy simulations show that insurance mandates for treatment or hard limits on treatment aggressiveness can improve access or costs, but not both. Insurance plus price-based incentives against risky treatment, however, can together improve patient welfare and reduce medical costs.

Suggested Citation

  • Barton H. Hamilton & Emily Jungheim & Brian McManus & Juan Pantano, 2018. "Health Care Access, Costs, and Treatment Dynamics: Evidence from In Vitro Fertilization," American Economic Review, American Economic Association, vol. 108(12), pages 3725-3777, December.
    • Handle: RePEc:aea:aecrev:v:108:y:2018:i:12:p:3725-77
    Note: DOI: 10.1257/aer.20161014
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    Citations

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    Cited by:

    1. Marie‐Louise Leroux & Pierre Pestieau & Gregory Ponthiere, 2024. "The optimal design of assisted reproductive technologies policies," Health Economics, John Wiley & Sons, Ltd., vol. 33(7), pages 1454-1479, July.
    2. Qi Li & Juan Pantano, 2023. "The demographic consequences of sex‐selection technology," Quantitative Economics, Econometric Society, vol. 14(1), pages 309-347, January.
    3. Yoshida, Jun, 2021. "Does disclosure of success rates induce patients to move to a better clinic? Evidence from In Vitro Fertilization," MPRA Paper 108441, University Library of Munich, Germany.
    4. Bhalotra, Sonia & Clarke, Damian & Mühlrad, Hanna & Palme, Mårten, 2021. "Health and Labor Market Impacts of Twin Birth : Evidence from a Swedish IVF Policy Mandate," The Warwick Economics Research Paper Series (TWERPS) 1391, University of Warwick, Department of Economics.
    5. Böckerman, Petri & Kortelainen, Mika & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2019. "Digital Waste? Unintended Consequences of Health Information Technology," Working Papers 117, VATT Institute for Economic Research.
    6. Matthew Grennan & Robert J. Town, 2020. "Regulating Innovation with Uncertain Quality: Information, Risk, and Access in Medical Devices," American Economic Review, American Economic Association, vol. 110(1), pages 120-161, January.
    7. Fabio I. Martinenghi & Xian Zhang & Luk Rombauts & Georgina M. Chambers, 2024. "Conceiving Naturally After IVF: the effect of assisted reproduction on obstetric interventions and child health at birth," Papers 2405.00234, arXiv.org, revised Sep 2024.
    8. Wu, Bingxiao, 2020. "Information presentation and firm response: Evidence from fertility clinics," Economics Letters, Elsevier, vol. 197(C).
    9. Dean, David & Pepper, John & Schmidt, Robert & Stern, Steven, 2019. "The effects of youth transition programs on labor market outcomes of youth with disabilities," Economics of Education Review, Elsevier, vol. 68(C), pages 68-88.
    10. Keller, Elena & Ortmann, Andreas & Chambers, Georgina Mary, 2024. "Exploring the demand for elective egg freezing: A laboratory experiment," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 111(C).

    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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