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<p>This thesis comprises three essays that empirically investigate important issues in two areas of health economics: physician labour supply and health insurance policy interventions.</p> <p>In the first essay, gendered associations between family status and physician labour supply are explored in the Canadian labour market, where physicians are paid according to a common fee schedule and have substantial discretion in setting their hours of work. Data from 1991 to 2006 show no gender difference in physician labour supply after controlling for family status. Male and female physicians have statistically indistinguishable hours of work when never married and without children. Married male physicians, however, have higher market hours than unmarried male physicians and parenthood either increases their hours or leaves them unchanged. In contrast, married female physicians have lower market hours than unmarried physicians and parenthood substantially lowers market hours. Little change over time in these patterns is observed for males, but for females two offsetting trends are observed: the magnitude of the marriage-hours effect declined, whereas that for motherhood increased. Preferences and/or social norms induce substantially different labour market outcome across the sexes. In terms of work at home, the presence of children is associated with higher hours for male physicians, but for females the hours increase is at least twice as large. A male physician’s spouse is much less likely to be employed in the presence of children, and if employed, has lower market hours in the presence of children. In contrast, a female physician’s spouse is more likely to be employed in the presence of children, and if employed, has slightly lower market hours in the presence of children. Both male and female physicians have lower hours of work when married to another physician.</p> <p>This second essay examines the impacts of a mandatory, universal prescription drug insurance program on health care utilization and health outcomes in a public health care system with free physician and hospital services. Beginning in 1997, all residents of the province of Quebec, Canada, were required by law to have drug insurance coverage. Under this program, all persons under age 65 who are eligible for a private plan are required to join that plan, while the public prescription drug insurance plan covers all Quebecers who are not eligible for a private plan. Using the National Population Health Survey from 1994 to 2003, we find that the mandatory program substantially increased drug coverage among the general population. The program also increased medication use and general practitioner visits but had little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there was a large improvement in the health status of less healthy individuals. Further analysis by pre-policy drug insurance status and the presence of chronic conditions reveals a marked increase in the probability of taking medication and visiting a general practitioner among the previously uninsured and those with a chronic condition. We also find evidence of positive health gains among the chronically ill.</p> <p>The third essay examines the impact of delisting routine eye exam services on patient eye care utilization and on providers’ labour market outcomes in a public health care system. Beginning in the early 1990s, provincial governments in Canada started to de-insure routine eye examinations from the basket of publicly funded health care services. We exploit delisting policy changes across Canadian provinces to estimate the impact of delisting from the supply- and demand-sides. Demand side analysis using the National Population Health Survey and Canadian Community Health Survey data suggests that the delisting of eye exams for the working age population decreased the probability of using eye care among this population group. However, the number of visits among those who continued to use eye care services was not affected. We also find suggestive evidence that the delisting policies targeted at the working age population were associated with increased eye care utilization among the elderly patients. Using the optometrist sample from the Canadian census data we find that the delisting of eye exams decreased optometrists’ weekly work hours while raised their annual work weeks. There was no statistically significant effect on optometrists’ income.</p> / Doctor of Philosophy (PhD)

Die vorliegende Dissertation untersucht die Kontextabhängigkeit von Konsumentenpräferenzen in Folge eines Marktaustritts in 4 Aufsätzen. Aufsatz 1 diskutiert Auswirkungen einer Auslistung auf Kundenreaktionen. Zwei empirische Studien belegen die Existenz eines negativen Ähnlichkeits-, Attraktions- und Kompromisseffektes und zeigen wesentliche Determinanten einer markentreuen Reaktion auf. Aufsatz 2 bestätigt die Hypothesen über negative Kontexteffekte für Markeneliminierungen in verschiedenen experimentellen Situationen und Produktkategorien. Das sich ergebende Substitutionsverhalten resultiert durchweg in höheren Verlusten für Hersteller als für Händler. Aufsatz 3 diskutiert das Substitutionsverhalten in Out-of-Stock Situationen. Promotion wird hierbei als wesentlicher Einflussfaktor herangezogen. Verschiedene Online-Experimente demonstrieren einen negativen Ähnlichkeitseffekt für die temporäre Nichtverfügbarkeit von Produkten, welcher sich jedoch für preisreduzierte Güter des täglichen Bedarfs verringert. Werden ähnliche Substitute preislich reduziert angeboten, wird der negative Ähnlichkeitseffekt verstärkt. Der Effekt wird hingegen von einem Attraktionseffekt überlagert, wenn unähnliche Alternativen im Sonderangebot sind. Aufsatz 4 untersucht wesentliche Einflussfaktoren eines negativen Attraktionseffektes. In Anlehnung an das von Mishra et al. (1993) entwickelte Kausalmodell zur Neuprodukteinführung, wird ein adaptiertes ganzheitliches Strukturgleichungsmodell für den Marktaustritt getestet. Als wesentliche Treiber des betrachteten Phänomens resultieren die Konstrukte Anteil des Decoys, Präferenzstärke und Informationsrelevanz. / This thesis investigates the context-dependence of preferences in consequence of market exits in 4 essays. Essay 1 discusses the effect of brand delisting on customer responses. On the basis of two empirical studies, the existence of a negative similarity, a negative attraction and a negative compromise effect is revealed and key determinants of a brand loyal reaction are analyzed. Essay 2 supports the hypotheses on negative context effects for brand removals across different experimental settings and product categories. The resultant switching patterns collectively lead to bigger damages for manufacturers than for retailers. Essay 3 investigates preference shifts in out-of-stock situations by including promotion as essential driver. A series of online experiments demonstrate that for temporal unavailability of products, substitution behavior correspond to a negative similarity effect which is, however, reduced for stock-outs of low involvement fast moving consumer goods on promotion. While the negative similarity effect is enforced for promotions of similar substitutes, it is ruled out by the simultaneous occurrence of an attraction effect when dissimilar substitutes are offered at a reduced price. Essay 4 studies important antecedent variables of the negative attraction effect. In reference to the causal model on product introduction developed by Mishra et al. (1993), an adapted holistic framework for product exit is tested by using structural equation modeling. The results emphasize decoy share, preference strength and information relevance as major drivers of the considered phenomenon.

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Submitted by Marco Tulio Padilha (tuliopadilha@hotmail.com) on 2014-12-23T14:36:38Z No. of bitstreams: 1 financas-Padilha-Projeto Entrega Final.pdf: 7936589 bytes, checksum: a4bbbf04a100d02d45ab1f91e604b6a4 (MD5) / Approved for entry into archive by Ana Luiza Holme (ana.holme@fgv.br) on 2014-12-23T14:38:49Z (GMT) No. of bitstreams: 1 financas-Padilha-Projeto Entrega Final.pdf: 7936589 bytes, checksum: a4bbbf04a100d02d45ab1f91e604b6a4 (MD5) / Made available in DSpace on 2014-12-23T15:32:09Z (GMT). No. of bitstreams: 1 financas-Padilha-Projeto Entrega Final.pdf: 7936589 bytes, checksum: a4bbbf04a100d02d45ab1f91e604b6a4 (MD5) Previous issue date: 2014-11-28 / Based on a sample of 119 companies that voluntarily delisted between 1999-2013, we investigated agency problems and access to capital as possible determinants to the delisting, controlling for cost to maintain the company listed, undervaluation, size, and stock liquidity. Proxies related to agency problems, such as higher ownership concentration, combined to lower return on assets, have strong influence on the stock delisting, as well as free cash flow and dividend payout. Regarding the use of capital markets to access follow on, as well as access to debt, we find that companies that delisted have less need to access the debt market, controlling for companies with the same profile. To the matter of control, we do not find evidence that cost to maintain the company listed nor the liquidity are determinant. / A partir de uma amostra de 119 empresas que deslistaram voluntariamente no período de 1999 a 2013, investigamos problemas de agência e acesso a capital como possíveis determinantes no fechamento de capital, controlando para custo de manter a empresa listada, sub-avaliação, tamanho e liquidez na bolsa. Proxies relacionadas a problemas de agência, tais como maior concentração de propriedade, combinado com menor retorno sobre ativos, possuem forte influência na deslistagem das ações, além de fluxo de caixa livre e distribuição de dividendos. Quanto ao uso de mercado de capitais para acesso a follow on, bem como acesso a dívida, encontramos que as empresas que deslistam possuem menor necessidade de acesso ao mercado de dívida, controlando para empresas com mesmo perfil. Para efeito de controle, não encontramos evidência de que custo de se manter listada nem que a liquidez sejam determinantes.

O presente trabalho tem por objeto o estudo do instituto da incorporação de ações. Para tanto, será analisado, (i) no primeiro capítulo, o regime legal vigente e sua natureza jurídica, apresentando-se as diferenças em relação à operação de incorporação de sociedade, fazendo inclusive um contraste com o direito norte-americano; (ii) no segundo capítulo, a proteção dos acionistas minoritários em operações de incorporação de controlada e eventual impedimento de voto do acionista controlador, analisando-se os recentes pareceres de orientação emitidos pela CVM; (iii) no terceiro capítulo, o estudo do instituto do tag along e do fechamento de capital e necessidade de realização de oferta pública em operações de incorporação de ações que impliquem transferência de controle ou cancelamento de registro de companhia aberta, à luz das últimas operações realizadas no mercado; (iv) no quarto capítulo, a discussão dos principais precedentes nos quais a CVM decidiu impor restrições ou impedir a realização de operações de incorporação de ações por entender ter havido um tratamento não equitativo entre os acionistas minoritários e controladores, com o objetivo de demonstrar a alteração do comportamento do órgão regulador no decorrer dos anos / The present work aims the study of the stock-for-stock exchange transactions (incorporação de ações). For this purpose, it will be examined (i) in the first part, the current legal regime and legal nature, contemplating differences with the statutory merger (incorporação de sociedade), including a comparison with the US law, (ii) in the second part, the protection of minority shareholders in the context of parent-subsidiary mergers and possible exclusion from voting of the controlling shareholder, taking into account the recent opinions issued by the Brazilian Securities and Exchange Commission (CVM), (iii) in the third part, the study of the tag along rights and the regulation for delisting companies and the need to conduct a tender offer in stock-for-stock exchange transactions involving transfer of control or delisting of a publicly-held company in light of recent transactions, and (iv) in the fourth part, the discussion of the key precedents on which CVM has decided to impose restrictions or prevent the conduct of stock-for-stock transaction under the understanding that there was inequitable treatment of minority shareholders and controlling shareholders, in order to demonstrate the change of the CVMs understanding over the years.

O presente trabalho tem por objeto o estudo do instituto da incorporação de ações. Para tanto, será analisado, (i) no primeiro capítulo, o regime legal vigente e sua natureza jurídica, apresentando-se as diferenças em relação à operação de incorporação de sociedade, fazendo inclusive um contraste com o direito norte-americano; (ii) no segundo capítulo, a proteção dos acionistas minoritários em operações de incorporação de controlada e eventual impedimento de voto do acionista controlador, analisando-se os recentes pareceres de orientação emitidos pela CVM; (iii) no terceiro capítulo, o estudo do instituto do tag along e do fechamento de capital e necessidade de realização de oferta pública em operações de incorporação de ações que impliquem transferência de controle ou cancelamento de registro de companhia aberta, à luz das últimas operações realizadas no mercado; (iv) no quarto capítulo, a discussão dos principais precedentes nos quais a CVM decidiu impor restrições ou impedir a realização de operações de incorporação de ações por entender ter havido um tratamento não equitativo entre os acionistas minoritários e controladores, com o objetivo de demonstrar a alteração do comportamento do órgão regulador no decorrer dos anos / The present work aims the study of the stock-for-stock exchange transactions (incorporação de ações). For this purpose, it will be examined (i) in the first part, the current legal regime and legal nature, contemplating differences with the statutory merger (incorporação de sociedade), including a comparison with the US law, (ii) in the second part, the protection of minority shareholders in the context of parent-subsidiary mergers and possible exclusion from voting of the controlling shareholder, taking into account the recent opinions issued by the Brazilian Securities and Exchange Commission (CVM), (iii) in the third part, the study of the tag along rights and the regulation for delisting companies and the need to conduct a tender offer in stock-for-stock exchange transactions involving transfer of control or delisting of a publicly-held company in light of recent transactions, and (iv) in the fourth part, the discussion of the key precedents on which CVM has decided to impose restrictions or prevent the conduct of stock-for-stock transaction under the understanding that there was inequitable treatment of minority shareholders and controlling shareholders, in order to demonstrate the change of the CVMs understanding over the years.