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Public and Private Options in Practice: The Military Health System

Author

Listed:
  • Michael D. Frakes
  • Jonathan Gruber
  • Timothy Justicz

Abstract

Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hospitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better outcomes, suggesting marginal efficiency gains from care privatization.

Suggested Citation

  • Michael D. Frakes & Jonathan Gruber & Timothy Justicz, 2023. "Public and Private Options in Practice: The Military Health System," American Economic Journal: Economic Policy, American Economic Association, vol. 15(4), pages 37-74, November.
    • Handle: RePEc:aea:aejpol:v:15:y:2023:i:4:p:37-74
    DOI: 10.1257/pol.20210625
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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H56 - Public Economics - - National Government Expenditures and Related Policies - - - National Security and War
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • 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
    • L33 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Comparison of Public and Private Enterprise and Nonprofit Institutions; Privatization; Contracting Out

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