In the U.S., the healthcare sector is highly regulated -- government regulation touches almost every dimension of healthcare, from health insurance to pharmaceuticals to medical services. The healthcare sector and the policies that govern it present an interesting setting to study many classic questions in public economics: how does regulation interact with or change individual and firm behavior? How do you monitor third parties who decide how to spend public funds? What happens when policy changes spill over from one segment of the economy to others? The three papers in this dissertation seek to answer these questions via the lens of the U.S. healthcare system. The first paper, "Job Lock, Retirement, and Dependent Health Insurance: Evidence from the Affordable Care Act,'' considers the extent to which changes in policies governing health insurance spill over onto individual labor market decisions. In particular, it looks at whether parents with young adult children eligible for the Affordable Care Act's dependent mandate delayed retirement to take advantage of the mandate. The second paper, "Regulated Revenues and Hospital Behavior: Evidence from a Medicare Overhaul'' (with Tal Gross, Adam Sacarny, and David Silver), considers how healthcare providers respond to changes in regulated prices. In it, we study a major reform that increased Medicare prices for some hospitals but decreased them for others, and consider how hospitals responded to these payment changes. Finally the third paper, "The Costs and Benefits of Monitoring Providers: Evidence from Medicare Audits,'' studies the efficacy of policies aimed at monitoring healthcare providers for wasteful expenditure. It studies a large monitoring program run by Medicare, and estimates the costs and benefits of this monitoring for the government, providers, and patients.

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to test hypotheses of four predictive relationships between (a) HI enrollment and HIL with HI terms; (b) marketplace enrollment and HIL with HI terms; (c) satisfaction with HI and HIL with HI access to care; and (d) satisfaction with HI and HIL with HI cost of care. Results indicated that participants with high HIL with HI terms had 4.2 times higher odds that those with low HIL to be enrolled in HI and 81% higher odds than those with low HIL to be enrolled in marketplace HI. The most significant relationship indicated that participants with high HIL with HI activities had 12.8 times higher odds than those with low HIL to have high satisfaction with access to care and 8.8 times higher odds than those with low HIL participants to have high satisfaction with cost of care. The finding that low HIL is associated with lower enrollment and lower satisfaction with HI has implications for social change. Policymakers may have the opportunity to utilize this study to promote policies that promote higher HIL, which may lead to increased HI enrollment and improved satisfaction with HI selection.

After the 2008 Global Financial Crash, Ireland’s neoliberal housing policy turned again to housing financialisation as focus lay upon the attraction of corporate investors in order to revive the housing market. The result was a swift return to housing price rises but this came with ever growing homelessness and housing precarity as REITs and other corporate investors' influence on the housing market grew. Affordability has become a common framing as one of the key issues which Ireland’s housing system is currently facing, by the state and researchers alike. However, much of this research frames housing issues and policies as being objectively defined. Social constructionism holds that housing issues and policy are heavily subjective, where material conditions are subjectively negotiated among competing narratives steeped in ideology and vested interests in an attempt to create a dominant narrative. This research, building upon a social constructionism approach, has analysed the negotiated process within the affordability discourse of Ireland. The key findings are that the state’s affordability narrative remains heavily linked to a commodified, private sector led housing provision which holds to its traditional liberal welfare regime. This narrative is reflected in the private sector’s narrative, which frames the state as a facilitator of the efficient private sector, which within a housing system free of state barriers, can create affordability. However, as more and more face into greater housing precarity as unaffordability grows, a counter narrative framing state built public housing, supported by the non-profit sector as key to reducing the reliance on a greedy private sector and in so doing, achieving affordability. As this movement grows, spearheaded by the increasing threat of Sinn Féin to parliamentary power and the growth of the trade union led Raise the Roof campaign movement, this counter narrative has grown in power. Although limited, there has been a shift in the state’s narrative which reflects that of the counter narrative where the state frames the need for a greater direct state role in affordable housing provision and state intervention as a control mechanism on the negative effects of the profit motive of the private sector. Although this can not be said to be a shift in welfare regime, it highlights the negotiated process of narratives within affordability discourse.

With the passage of the Affordable Care Act, states were given the option to expand their Medicaid programs. Since then, thirty-eight states and Washington, D.C., have done so. Previous work has identified the widespread effects of expansion on enrollment and the financial implications for individuals, hospitals, and the federal government, yet administrative expenditures have not been considered. Using data from all fifty states for the period 2007-17, our study estimated the effects of Medicaid expansion overall, as well as differing effects by the size and nature of the expansions. Using a quasi-experimental approach, we found no overall effect of expansion on administrative spending. However, the size of the expansion may have produced differing effects. States with small expansions experienced some increases in administrative spending, whereas states with large expansions experienced some decreases in administrative spending, including a $77 reduction in per enrollee administrative spending compared with nonexpansion states. As more states consider expanding their Medicaid programs, our findings provide evidence of potential effects.

American’s agree that dental health is important and vital to our overall wellbeing. However, not every American is achieving the same degree of oral health. Obstacles that American’s face include dental health disparities, limited access to affordable dental care, and limited access to dental insurance. This study examined how disease risk is shaped within the culture of oral health in Florida. This study examined those who provide dental care, those who cannot afford dental health insurance but earn too much money to qualify for Medicaid, and those with dental insurance. Hypotheses two and three were proven to be true, while hypotheses one and four were proven to be false. Research indicated that the participants believe that pleasingly aesthetic teeth are highly desirable. It revealed that the poor and working poor are unable to utilize dental health insurance, and do not seek annual preventive dental health services due to the cost.

Access to affordable high-quality health care solutions is a global challenge, especially in emerging markets where health care systems are the most resource constrained. The socio-economic benefits of investing in health care are considerable, especially in terms of improvement of life quality and economic development. This creates a strong demand for efficient health care delivery models with good health outcomes. In particular, health programs targeting children in their formative years can have a longlasting effect on the children’s and their families’ lives. In India, which has one of the highest burdens of disease in the world, many states lack adequate school health programs. To address this need, the NICE Foundation has developed a school health program that provides free health care to over 200,000 children. The NICE Foundation has experienced a great interest in their school health model and thus aims to expand their operations. This study analyses the characteristics of the school health program in order to identify future opportunities and to provide strategic advice for the expansion of the NICE Foundation School Health Program. / Tillgång till prisvärd och högkvalitativ sjukvård är en global utmaning, i synnerhet i tillväxtländer där sjukvårdssystemen  är mycket  resursbegränsade.  De socio-ekonomiska  fördelarna  av att investera  i sjukvård  är avsevärda,  med förbättrad  livskvalitet  och ekonomisk  utveckling  som följd.  Det  finns  därför  en  stor  efterfrågan  på  effektiva  hälsomodeller  som  renderar  goda hälsoresultat.   Särskilt  hälsoprogram   som  är  inriktade  på  barn  i  deras  formativa  år  har dokumenterats ge långtgående positiva effekter för individerna och samhället. I Indien, som har en  av  de  högsta  nivåerna   av  sjukdomsbörda   i  världen,   saknar  många  av  delstaterna skolhälsoprogram.   För   att   addressera   detta   behov   har   NICE   Foundation   utvecklat   ett skolhälsoprogram   som  i  nuläget  erbjuder  gratis  sjukvård  för  över  200  000  barn.  NICE Foundation  skolhälsomodell  har  fått  mycket  positiv  respons  och  organisationen  ämnar  att expandera  programmet.  Denna  studie  analyserar  NICE  Foundation  skolhälsomodell  för  att identifiera framtida möjligheter samt för att tillhandahålla strategiska råd för expansion.

The housing shortage in Swedish growth regions has been heatedly debated for a number of years. Extensive reform proposals have been made by market actors and academics. The former center–right government in power until 2014 emphasized reform of the urban planning process. The current “red–green” government has ongoing planning reform on its agenda, but has instead emphasized investment subsidies. In the debate, the German housing market has been put forward as a positive example. This licentiate thesis compares the early stages of housing development in Germany and Sweden to find any differences that could provide interesting points of discussion related to further housing market reform in Sweden. As the scope of such an analysis could be very wide, this thesis is restricted to urban planning law and implementation, and to city initiatives to increase housing supply, including the affordable housing segment. The first step of the research project was to identify the major problems related to Swedish planning law and its implementation and to map the current state of reform. The identified problems encompassed issues related to municipal strategies for housing construction, the urban planning process, the appeal process, areas classified as of national interest, regulations, development agreements, and municipal land allocation. The article “The Planning Process in Sweden: current debate and reform proposals” summarizes the government inquiries, bills, and reforms introduced to date and gives an outlook on possible future urban planning reform in light of recent political developments. Second, the urban planning and appeal processes in Germany and Sweden were compared. The article “Promoting Planning for Housing Development: what can Sweden learn from Germany?” discusses three alternative processes in German local planning (i.e., private initiative, facilitated procedures in built-up areas, and omission of the local plan under certain circumstances) as well as the organization of planning authorities and city demands for affordable housing. The conclusion includes a proposal for a facilitated local housing plan, the introduction of private initiative in planning, and ways to improve planning authority organization in Sweden. When it comes to planning-related city demands for affordable housing, more research drawing on extensive international experience is required. Third, city strategies for housing construction were compared in the article “City Strategies for Affordable Housing: the approaches of Berlin, Hamburg, Stockholm and Gothenburg.” Although the housing shortages in these four cities differ somewhat in structure, the tools for implementing housing policy related to construction are similar and address organization, urban planning, land allocation, and subsidies. The German cities have a more active housing policy, cooperating with developers and using tools more consistently, than do their Swedish counterparts. They are also more likely to reach their construction goals. The overall findings of the research project stress the importance of political incentives in the formation of active housing policy. / <p>QC 20151216</p>

Denna multipla fallstudie behandlar hur kommuner implementerar de bostadssociala målen i sina markanvisningar. Sveriges befolkning växer och fler bostäder behöver byggas för att människor ska ha någonstans att bo. Bristen på bostäder får stora konsekvenser både på individnivå och för samhället i stort när bostadsbristen hämmar samhällsutvecklingen. De som drabbas hårdast av detta är de med låg inkomst, studenter, ungdomar, pensionärer, socialt utsatta och nyanlända. För att skapa rätt förutsättningar för alla invånare i kommunerna ska målen för bostadsförsörjningen beskrivas i bostadspolitiska program och kopplas till översiktsplanerna (SFS 2000:1383). Behovet av att bygga bostäder för låginkomsttagare är stort, bland andra studenter, ungdomar och äldre, kommunerna kan genom sina markanvisningar ställa krav på byggherrarna om att uppföra sådana bostäder. Syftet med detta arbete är att kartlägga hur två kommuner arbetar med markanvisning för att nå de sociala målen i bostadspolitiken och försöka besvara följande frågeställningar: • Hur kommer de bostadssociala målen gällande studenter, ungdomar samt bostäder för äldre och 55+ till uttryck i markanvisningar? • Hur skiljer sig de bostadssociala målen i markanvisningarna mellan Sundbybergs stad och Täby kommun? De i uppsatsen granskade markanvisningarna visar på att det i kommunerna byggs bostäder för den breda allmänheten men även i viss mån riktat mot grupper med lägre inkomster. Studien visar även att olika politisk styrning påverkar bostadsförsörjningen i olika riktning. Samt att vikten av att ha tydliga mål för bostadsförsörjningen leder till att bostadsbyggandet får en tydlig inriktning. Motsatsvis får avsaknaden av mål för bostadsförsörjningen negativa konsekvenser i form av uteblivna bostäder för ungdomar, studenter och äldre och 55+. / This multiple case study deals with how municipalities implement their housing supply objectives in their land allocations. Sweden’s population is growing and more housing needs to be built for people to have somewhere to live. The lack of housing has major consequences both at the individual level and for society at large when housing shortages hamper social and economic development. Those who are most affected by this are those with low incomes, for example adolescents, students and senior citizens. In order to create the right conditions for all residents in the municipalities, the housing supply objective should be described in housing policy programs and linked to the comprehensive plan (SFS 2000:1383). If there is a need to build residences for lower-income citizens, including adolescents, students and senior citizens, municipalities may, through their land allocations, induce the developers to construct such housing. The purpose of this study is to examine how two municipalities in the greater Stockholm region work with their land allocations to reach the objectives of their housing supply objectives and try to answer the following questions: • How will the housing supply objectives be expressed in land allocations regarding students, adolescents and senior citizens and 55+? • How does the housing supply objectives in the land allocation differ between Sundbybergs stad and Täby kommun? Conclusions from the study show that different political views, where basic principles on how to govern a municipality effectively, lead to, among other things, the housing supply objectives in different paths. One path does not favor those with low income, the other tries to do something. Different political views affect housing construction in Sweden, the question has therefore been raised that housing construction should be handled at the national level.

Hurricane Katrina overwhelmed the government's capacity to provide adequate long-term housing to disaster victims. In response, Congress created a pilot program to test the efficacy of permanent disaster housing prototypes known as "Katrina Cottages." However, implementation was hindered by a lack of planning and local opposition. In Mississippi, residents feared adverse impacts to property values, citing poor design quality resembling manufactured mobile homes as a primary concern. Using standardized local tax appraisals, this study finds that Katrina Cottages are valued significantly higher than manufactured homes. It further reveals no significant difference between Katrina Cottages and single-family homes. It also suggests a strong relationship between value and smart growth design metrics, including density, walkability, and urban context. However, it shows that Mississippi Katrina Cottages are valued lower than those in Alabama and Louisiana. Furthermore, analysis of community demographics suggests Katrina Cottages may be less valuable in wealthy communities.

Idag är det dyrt och svårt att ta sig in på bostadsmarknaden i Norden då det både är höga marknadspriser och långa köer till vissa marknadssegment, detta blir speciellt ett problem för de mer resurssvaga hushållen. Åtkomliga bostäder handlar om hur man genom olika modeller kan tillhandahålla bostäder till överkomligt pris för låg- och medelinkomsttagare. Dessa bostäder är inte speciellt inriktat på missgynnade grupper, till exempel drogmissbrukare eller de med svåra psykiska problem, utan de grupper där problemet endast är en låg inkomst. Det kan alltså handla om unga vuxna, immigranter, studerande eller hushåll med lägre inkomster. Begreppet åtkomlig bostad är dock relativt då två hushåll med samma inkomst kan ha olika utgifter beroende av bland annat hushållets och bostadens storlek och vart bostaden är belägen. Det samma gäller synen på vad som är en åtkomlig bostad då den kan variera både mellan städer och länder.  Denna litteraturstudie utfördes för att undersöka hur de nordiska ländernas jobb med att gynna åtkomliga bostäder återspeglas i den vetenskapliga litteraturen. Resultatet i studien visar bland annat att allmännyttiga bostadsbolag och organisationer är betydande i de nordiska länderna för att tillgodose allmänheten med bostäder. Oftast är delar av detta bestånd också sociala bostäder. Hur stor del de tar upp av det totala beståndet och vilken roll de har varierar mellan länderna. En annat relativt nytt sätt att främja åtkomliga bostäder är genom inkluderande bostadsbyggande. Kommunen använder sig av olika verktyg inom planeringssystemet för att se till att det vid nya projekt byggs en viss del billigare bostäder eller bostäder som ska riktas till en viss grupp. Detta sker med varierande metoder i de olika länderna då mycket beror på hur landets regelsystem ser ut. Olika typer av ekonomiskt stöd riktade både mot invånare och till projektutvecklare finns i länderna. Bostadsbidrag för att stötta hushållen beskrivs som ett stöd som är enklare att koncentrera till just de som behöver. Detta då de subventioner som går till projektutvecklare gör träffsäkerheten svår. Andra mindre alternativ för att lösa tillgången till åtkomliga bostäder finns också men här diskuteras det om de ens har en speciellt stor inverkan då de endast görs i mindre projekt. De mer lyckade alternativen lyfts fram i diskussionen som möjliga förslag att införa i andra länder. Bland annat så är ett subventionerat bosparande för unga som finns i Norge en möjlig lösning för andra länder att använda sig av. / It is expensive and difficult to enter the housing market in the Nordic countries today as there are both high market prices and the housing queues for certain market segments are long, and this will be a particular problem for the more resource-poor households. Affordable housing is about how to provide housing that is affordable to the low- and middle-income earners through different models. These homes are not specifically targeted at disadvantaged groups, such as drug addicts or those with severe mental health problems, but the groups with the problem of a low income. It can thus be about young adults, immigrants, students or households with lower incomes. However, the concept of affordable housing is relative as two households with the same income may have different expenses depending on the size of the household and the dwelling, among other things. The same applies to the view of what is an accessible home as it can vary between cities and countries. This literature study was conducted to examine how the Nordic countries work to promote affordable housing are reflected in the scientific literature. The results of the study show, among other things, that public housing companies and organizations are significant in providing the public with housing in the Nordic countries. Most often, parts of this stock are also social housing. How much they take up of the total stock and what role they play varies between countries. Another relatively new way of promoting accessible housing is through inclusionary housing. The municipality uses various tools within the planning system to ensure that new building projects include a certain amount of cheaper housing or housing that is to be targeted at a certain group. This is done with varying methods in the different countries as it depends on what the country's system of regulations looks like. Different types of financial support aimed at both residents and developers exist in the countries. Housing allowance to support households is described as a support that is easier to concentrate on those who need it. This is because the subsidies that go to the developers makes it difficult with accuracy. There are also other smaller alternatives for solving the availability of affordable housing, but the discussion is whether they even have an impact as they are only done in smaller projects. The more successful alternatives are highlighted in the discussion as possible ideas to introduce in other countries. For example, a subsidized housing saving for young people in Norway is a possible solution for other countries to use.