Counting the Dead: COVID-19 and Mortality in Quebec and British Columbia During the First Wave.

The first wave of the COVID-19 pandemic has led to excess mortality across the globe, and Canada has been no exception. Nonetheless, the pandemic experience has been very different across provinces, and the objective of this paper is to investigate these differences focusing on two extreme cases. We contrast the mortality experience of British Columbia with that of Québec to understand how large differences in mortality during the first wave of the pandemic emerged across these two provinces.

Accounting for the Rise of Health Spending and Longevity.

We estimate a stochastic life-cycle model of endogenous health spending, asset accumulation and retirement to investigate the causes behind the increase in health spending and longevity in the U.S. over the period 1965-2005.

Early Impact of the COVID-19 Pandemic on Household Finances in Quebec.

The coronavirus disease 2019 (COVID-19) pandemic surged in early March 2020, with unemployment reaching historic levels in April 2020. This study paints an early portrait of the pandemic's impact on the finances of households in Quebec, one of the hardest-hit provinces in terms of COVID-19 cases as well as unemployment levels. The article also provides an understanding of how government emergency benefit programs may have helped households get by during the early period of the pandemic.

Understanding Joint Retirement.

Evidence from different sources shows that spouses' retirement decisions are correlated. Retirement policies affecting individuals in couples are therefore also likely to affect behavior of their spouses. It is therefore important to account for joint features in modeling retirement.

The effect of college education on health and mortality: Evidence from Canada.

We investigate the returns to college attendance in Canada in terms of health and mortality reduction. To do so, we first use a dynamic health microsimulation model to document how interventions that incentivize college attendance among high school graduates may impact their health trajectory, health care consumption, and life expectancy. We find large returns both in terms of evity (4.

The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada.

Objectives: We assess how different scenarios of cardiovascular disease (CVD) prevention, aimed at meeting targets set by the World Health Organization (WHO) for 2025), may impact healthcare spending in Quebec, Canada over the 2050 horizon.

Methods: We provide long-term forecasts of healthcare use and costs at the Quebec population level using a novel dynamic microsimulation model. Using both survey and administrative data, we simulate the evolution of the Quebec population's health status until death, through a series of dynamic transitions that accounts for social and demographic characteristics associated with CVD risk factors.

Distribution of lifetime nursing home use and of out-of-pocket spending.

Reliable estimates of the lifetime risk of using a nursing home and the associated out-of-pocket costs are important for the saving decisions by individuals and families, and for the purchase of long-term care insurance. We used data on up to 18 y of nursing home use and out-of-pocket costs drawn from the Health and Retirement Study, a longitudinal household survey representative of the older US population. We accumulated the use and spending by individuals over many years, and we developed and used an individual-level matching method to account for use before and after the observation period.

The Effect of Job Loss on Health: Evidence from Biomarkers.

We estimate the effect of job loss on objective measures of physiological dysregulation using biomarker measures collected by the Health and Retirement Study in 2006 and 2008 and longitudinal self-reports of work status. We distinguishing between mass or individual layoffs, and business closures. Workers who are laid off from their job have lower biomarker measures of health, whereas workers laid off in the context of a business closure do not.

End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported.

Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009-11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Quebec to measure the composition and magnitude of medical spending in the three years before death. In all nine countries, medical spending at the end of life was high relative to spending at other ages.

Individual survival curves comparing subjective and observed mortality risks.

We compare individual survival curves constructed from objective (actual mortality) and elicited subjective information (probability of survival to a given target age). We develop a methodology to estimate jointly subjective and objective individual survival curves accounting for rounding on subjective reports of perceived survival. We make use of the long follow-up period in the Health and Retirement Study and the high quality of mortality data to estimate individual survival curves that feature both observed and unobserved heterogeneity.

The economic consequences of obesity and overweight among adults in Quebec.

Objectives: This article presents the first study of the economic consequences of obesity and overweight in the Canadian province of Quebec. The article examines three types of direct costs: hospitalizations, medical visits and drug consumption; and one type of indirect cost: productivity loss due to disability.

Methods: The National Population Health Survey, conducted in all Canadian provinces by Statistics Canada between 1994 and 2011, provides self-reported longitudinal data for body mass index and the frequency of health care utilization and disability.

Disease incidence and mortality among older Americans and Europeans.

Recent research has shown a widening gap in life expectancy at age 50 between the United States and Europe as well as large differences in the prevalence of diseases at older ages. Little is known about the processes determining international differences in the prevalence of chronic diseases. Higher prevalence of disease could result from either higher incidence or longer disease-specific survival.

Substantial health and economic returns from delayed aging may warrant a new focus for medical research.

Recent scientific advances suggest that slowing the aging process (senescence) is now a realistic goal. Yet most medical research remains focused on combating individual diseases. Using the Future Elderly Model--a microsimulation of the future health and spending of older Americans--we compared optimistic "disease specific" scenarios with a hypothetical "delayed aging" scenario in terms of the scenarios' impact on longevity, disability, and major entitlement program costs.

The Displacement Effect of Public Pensions on the Accumulation of Financial Assets.

The generosity of public pensions may depress private savings and provide incentives to retire early. While there is plenty of evidence supporting the latter effect, there remains considerable controversy whether public pensions crowd out private savings. This paper uses international micro-datasets collected over recent years to investigate whether public pensions displace private savings.

A health production model with endogenous retirement.

We formulate a stylized structural model of health, wealth accumulation and retirement decisions building on the human capital framework of health and derive analytic solutions for the time paths of consumption, health, health investment, savings and retirement. We argue that the literature has been unnecessarily restrictive in assuming that health is always at the 'optimal' health level. Exploring the properties of corner solutions, we find that advances in population health decrease the retirement age, whereas at the same time, individuals retire when their health has deteriorated.

The value of medical and pharmaceutical interventions for reducing obesity.

This paper attempts to quantify the social, private, and public-finance values of reducing obesity through pharmaceutical and medical interventions. We find that the total social value of bariatric surgery is large for treated patients, with incremental social cost-effectiveness ratios typically under $10,000 per life-year saved. On the other hand, pharmaceutical interventions against obesity yield much less social value with incremental social cost-effectiveness ratios around $50,000.

An Analysis of the Labor Markets for Anesthesiology.

The roughly 40,000 anesthesiologists (ANs) and anesthesiology residents and 39,000 licensed certified registered nurse anesthetists (CRNAs) and student CRNAs in the United States provide most anesthesiology services. Shortages in this critical area of health care can lead to problems in the provision of health services. The authors' surveys of ANs, CRNAs, and anesthesiology directors included questions about employer types, work hours, earnings, types of anesthesia provision, and technology adoption and preferences.

Differences in health between Americans and Western Europeans: Effects on longevity and public finance.

In 1975, 50-year-old Americans could expect to live slightly longer than most of their Western European counterparts. By 2005, American life expectancy had fallen behind that of most Western European countries. We find that this growing longevity gap is primarily due to real declines in the health of near-elderly Americans, relative to their Western European peers.

Using matched survey and administrative data to estimate eligibility for the Medicare Part D low-income subsidy program.

This article uses matched survey and administrative data to estimate, as of 2006, the size of the population eligible for the Low-Income Subsidy (LIS), which was designed to provide "extra help" with premiums, deductibles, and copayments for Medicare Part D beneficiaries with low income and limited assets. We employ individual-level data from the Survey of Income and Program Participation and the Health and Retirement Study to cover the potentially LIS-eligible noninstitutionalized and institutionalized populations of all ages. The survey data are matched to Social Security administrative data to improve on potentially error-ridden survey measures of income and program participation.

The benefits of risk factor prevention in Americans aged 51 years and older.

Objectives: We assessed the potential health and economic benefits of reducing common risk factors in older Americans.

Methods: A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project their health and medical spending in prevention scenarios for diabetes, hypertension, obesity, and smoking.

Results: The gain in life span from successful treatment of a person aged 51 or 52 years for obesity would be 0.

U.S. pharmaceutical policy in a global marketplace.

U.S. consumers generate more pharmaceutical revenue per person than Europeans do.

Health and wealth of elderly couples: causality tests using dynamic panel data models.

A positive relationship between socio-economic status (SES) and health, the "health-wealth gradient", is repeatedly found in many industrialized countries. This study analyzes competing explanations for this gradient: causal effects from health to wealth (health causation) and causal effects from wealth to health (wealth or social causation). Using six biennial waves of couples aged 51-61 in 1992 from the US Health and Retirement Study, we test for causality in panel data models incorporating unobserved heterogeneity and a lag structure supported by specification tests.

How did the Elimination of the Earnings Test above the Normal Retirement Age affect Retirement Expectations?

We look at the effect of the 2000 repeal of the earnings test above the normal retirement age on retirement expectations of workers in the Health and Retirement Study, aged 51 to 61 in 1992. For men, we find that those whose marginal wage rate increased when the earnings test was repealed, had the largest increase in the probability to work full-time past normal retirement age. We do not find significant evidence of effects of the repeal of the earnings test on the probability to work past age 62 or the expected claiming age.