<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)

This DPhil thesis comprises three empirical essays that survey the evolution of gender differences in the labour market of urban Colombia since the 1980s. The first essay examines the evolution of gender segregation using occupational indices between 1986 and 2004, and presents a decomposition of their changes over time using a technique proposed by Deutsch et al. (2006). We find that a substantial proportion of the reduction in segregation indices is driven by changes in both the employment structure of occupations and the increasing participation of female labour observed over these years. The second essay assesses the effects of occupational segregation on the gender wage gap in urban Colombia between 1984 and 1999. The empirical strategy involves the estimation of a counterfactual distribution of female workers across occupations, as if they had been treated the same as their male counterparts. This provides a basis to formulate a decomposition of the gender wage gap in which the explained and unexplained portions of the gender distribution of jobs are explicitly incorporated. The results indicate that the unequal distribution of women and men across occupations actually helps, on average, to reduce gender pay differences in urban Colombia, particularly in the ‘informal' segment where the labour income differential between women and men is the largest. The third and final essay examines the effects of trade liberalisation on the gender composition of employment across manufacturing industries in urban Colombia from 1981 to 2000. The empirical strategy involves a comparison of estimates drawn from different panel data techniques. As a main finding, we verify that increasing trade flows are associated with higher proportions of female employment.

The purpose of this thesis has been to analyse seven major factors that tend to influence the rate of early retirement in Sweden. The scope of data was gathered for every municipality in Sweden. Economic theories of labour supply, Moral Hazard, Adverse Selection and the Insurance Model were used to analyse the empirical results. In the analysis, earlier studies of the rate of sickness absence were important and used as a framework in choosing the explanatory variables for the econometric model. The analysed variables were; average income, average sickness days, educational level, foreign born, public sector employment, unemployment and the share of women in the population. As a consequence of the rift that occurred in 2003, when the average sickness days decreased and disbursed early retirements simultaneously increased, the relationship between these two variables was given special attention. The empirical findings confirmed our conjectures and were consistent with earlier research. Average income and the level of education were negatively related to the rate of early retirement. Moreover foreign born, average sickness days and unemployment showed a positive relation to early retirement. The relationship between average sickness days and early retirement had statistically changed and decreased between the years. A possibility is that other factors, such as changed social norms and increased stress in society (which are difficult to measure in a statistical and economical sense) might have become more relevant in explaining the rate of early retirement. / Syftet med denna uppsats har varit att analysera sju viktiga faktorer som tenderar att påverka graden av förtidspensionering i Sverige. Data omfånget insamlades för alla kommuner i Sverige. Ekonomiska teorier om arbetsutbud, Moral Hazard, Adverse Selection och Insurance Model användes för att analysera de empiriska resultaten. I analysen var tidigare studier utav graden av sjukfrånvaro viktig och användes som ramverk i valet av de förklarande variablerna till den ekonometriska modellen. De analyserade variablerna var; medelinkomst, genom-snittliga sjukdagar, utbildningsnivå, utlandsfödda, offentligt anställda, arbetslöshet och andelen kvinnor i befolkningen. Som en konsekvens utav den klyfta som uppstod 2003, när de genomsnittliga sjukdagarna minskade och utbetalda förtidspensioner samtidigt ökade, gavs sambandet mellan dessa två variabler speciell uppmärksamhet. De empiriska iakttagelserna bekräftade våra förväntningar och stämde överens med tidigare forskning. Medelinkomst och utbildningsnivå var negativt relaterade till graden av förtidspensionering. Dessutom var utlandsfödd, genomsnittliga sjukdagar och arbetslöshet positivt relaterade till förtidspensionering. Relationen mellan de genomsnittliga sjukdagarna och graden av förtidspensionering hade statistiskt sätt ändrats genom att ha minskat mellan åren. En tänkbar förklaring till detta skulle kunna vara att andra faktorer, såsom skiftande sociala normer och en ökande stress i samhället (vilka är svåra att mäta statistiskt och ekonomiskt) kan ha blivit mer relevanta i att förklara graden av förtidspensionering.

Partendo dalla constatazione della sempre maggiore complessità del contesto economico e sociale nazionale ed internazionale, imputabile da un lato al processo di integrazione economico e monetario europeo, e dall'altro alla progressiva decentralizzazione dei poteri a livello regionale, la tesi intende proporsi come uno strumento analitico di supporto al decisore. A tal fine, in base a dati annui di fonte ISTAT-SVIMEZ per il periodo 1970-2003, viene sviluppato un modello econometrico regionale 'globale' per il mercato del lavoro italiano, estendendo un precedente modello mono-regionale proposto da Baussola (2003), ad un contesto pluri-regionale. Il modello conduce non solo a rappresentare soddisfacentemente i mercati regionali italiani, ma opera altresì efficacemente nel ricostruire i valori delle variabili a livello nazionale. Il modello si conferma robusto ed efficace nel rappresentare le realtà regionali, anche nell'ottica di analisi propria dell'econometria delle serie storiche. / The starting point of this thesis is the remark that recent decades have been characterized by a rising complexity in the economic and political context both at the national and international level. This is due both to the European economic and monetary integration process and to the regional decentralisation process. With the aim of providing a useful tool of analysis for the decision-maker,. a 'global' regional model for the Italian labour market has been constructed on the basis of annual data from ISTAT-SVIMEZ over the 1970-2003 period. This model could be viewed as an extension to a multi-regional framework of the previous one-region model developed by Baussola (2003). The model shows good performance not only in representing regional labour market specificities, but also in reproducing national variable values. It is also robust and effective in a time-series context.

The Labour Supply of Unpaid Caregivers in Canada, Doctor of Philosophy (PhD), Meredith Lenore Lilly, Department of Health Policy, Management and Evaluation, University of Toronto, 2008. As medical care increasingly shifts from the hospital to the home, responsibility for care has also shifted from the state and paid care, to the family and unpaid care. Unpaid caregivers are family members and friends who provide homecare services to recipients in their place of residence without financial compensation, as a result of their close personal relationships. This research tests the multiple hypotheses that unpaid caregiving has an impact on (1) the probability of labour force participation (LFP); (2) hours of labour force work; and (3) earnings by caregivers in Canada. We analyzed the 1996 and 2002 General Social Surveys, applying multivariate probit, logistic, and OLS regression analyses to four equations: 1) the probability of labour force participation; 2) the hourly wage; 3) weekly hours of labour market work; and 4) the probability of being an unpaid caregiver. Results indicate that unpaid caregiving was negatively associated with labour force participation; however, the impact on hours of labour market work and wages was uncertain. Women and men caregivers were impacted differently: only caregiving men in 1996 had significantly lower wages than non-caregivers, and only women in 1996 worked significantly fewer hours in the labour market. When caregiving was defined broadly, only men in 1996 were significantly less likely to be employed than non-caregivers. Yet when we controlled for caregiving intensity in 2002, both male and female primary caregivers were much less likely to be in the labour force than non-caregivers, while secondary caregivers were no less likely to be employed than non-caregivers. We conclude that when caregiving responsibilities are relatively small, individuals seem able to balance both caregiving with employment. Yet when caregiving commitments become heavy, it becomes increasingly difficult to balance employment with caregiving. We make a number of policy recommendations ranging from improving caregiver access to financial supports, formal care and respite services, particularly for primary caregivers. We also encourage the development of workplace legislation and caregiver friendly workplaces for the majority of caregivers who remain in the labour market.

The Labour Supply of Unpaid Caregivers in Canada, Doctor of Philosophy (PhD), Meredith Lenore Lilly, Department of Health Policy, Management and Evaluation, University of Toronto, 2008. As medical care increasingly shifts from the hospital to the home, responsibility for care has also shifted from the state and paid care, to the family and unpaid care. Unpaid caregivers are family members and friends who provide homecare services to recipients in their place of residence without financial compensation, as a result of their close personal relationships. This research tests the multiple hypotheses that unpaid caregiving has an impact on (1) the probability of labour force participation (LFP); (2) hours of labour force work; and (3) earnings by caregivers in Canada. We analyzed the 1996 and 2002 General Social Surveys, applying multivariate probit, logistic, and OLS regression analyses to four equations: 1) the probability of labour force participation; 2) the hourly wage; 3) weekly hours of labour market work; and 4) the probability of being an unpaid caregiver. Results indicate that unpaid caregiving was negatively associated with labour force participation; however, the impact on hours of labour market work and wages was uncertain. Women and men caregivers were impacted differently: only caregiving men in 1996 had significantly lower wages than non-caregivers, and only women in 1996 worked significantly fewer hours in the labour market. When caregiving was defined broadly, only men in 1996 were significantly less likely to be employed than non-caregivers. Yet when we controlled for caregiving intensity in 2002, both male and female primary caregivers were much less likely to be in the labour force than non-caregivers, while secondary caregivers were no less likely to be employed than non-caregivers. We conclude that when caregiving responsibilities are relatively small, individuals seem able to balance both caregiving with employment. Yet when caregiving commitments become heavy, it becomes increasingly difficult to balance employment with caregiving. We make a number of policy recommendations ranging from improving caregiver access to financial supports, formal care and respite services, particularly for primary caregivers. We also encourage the development of workplace legislation and caregiver friendly workplaces for the majority of caregivers who remain in the labour market.

<p>The purpose of this thesis has been to analyse seven major factors that tend to influence the rate of early retirement in Sweden. The scope of data was gathered for every municipality in Sweden. Economic theories of labour supply, Moral Hazard, Adverse Selection and the Insurance Model were used to analyse the empirical results. In the analysis, earlier studies of the rate of sickness absence were important and used as a framework in choosing the explanatory variables for the econometric model. The analysed variables were; average income, average sickness days, educational level, foreign born, public sector employment, unemployment and the share of women in the population. As a consequence of the rift that occurred in 2003, when the average sickness days decreased and disbursed early retirements simultaneously increased, the relationship between these two variables was given special attention. The empirical findings confirmed our conjectures and were consistent with earlier research. Average income and the level of education were negatively related to the rate of early retirement. Moreover foreign born, average sickness days and unemployment showed a positive relation to early retirement. The relationship between average sickness days and early retirement had statistically changed and decreased between the years. A possibility is that other factors, such as changed social norms and increased stress in society (which are difficult to measure in a statistical and economical sense) might have become more relevant in explaining the rate of early retirement.</p> / <p>Syftet med denna uppsats har varit att analysera sju viktiga faktorer som tenderar att påverka graden av förtidspensionering i Sverige. Data omfånget insamlades för alla kommuner i Sverige. Ekonomiska teorier om arbetsutbud, Moral Hazard, Adverse Selection och Insurance Model användes för att analysera de empiriska resultaten. I analysen var tidigare studier utav graden av sjukfrånvaro viktig och användes som ramverk i valet av de förklarande variablerna till den ekonometriska modellen. De analyserade variablerna var; medelinkomst, genom-snittliga sjukdagar, utbildningsnivå, utlandsfödda, offentligt anställda, arbetslöshet och andelen kvinnor i befolkningen. Som en konsekvens utav den klyfta som uppstod 2003, när de genomsnittliga sjukdagarna minskade och utbetalda förtidspensioner samtidigt ökade, gavs sambandet mellan dessa två variabler speciell uppmärksamhet. De empiriska iakttagelserna bekräftade våra förväntningar och stämde överens med tidigare forskning. Medelinkomst och utbildningsnivå var negativt relaterade till graden av förtidspensionering. Dessutom var utlandsfödd, genomsnittliga sjukdagar och arbetslöshet positivt relaterade till förtidspensionering. Relationen mellan de genomsnittliga sjukdagarna och graden av förtidspensionering hade statistiskt sätt ändrats genom att ha minskat mellan åren. En tänkbar förklaring till detta skulle kunna vara att andra faktorer, såsom skiftande sociala normer och en ökande stress i samhället (vilka är svåra att mäta statistiskt och ekonomiskt) kan ha blivit mer relevanta i att förklara graden av förtidspensionering.</p>

Avec le vieillissement général de la population et ses implications sur la pérennité des finances publiques, le marché du travail des seniors est un thème qui va continuer à préoccuper nos sociétés. L’objectif de cette thèse est de répondre à des problématiques concrètes relatives au marché du travail des personnes âgées. Cette thèse comprend quatre chapitres. Les deux premiers chapitres s’intéressent à l’évolution des trajectoires salariales en fin de carrière professionnelle. Les résultats ne supportent pas l’idée que les salaires décroissent pour les travailleurs âgés à cause de l’âge. La diminution du salaire observée pour les travailleurs âgés en coupe transversale est le résultat d’effet de cohorte, de changement d’emploi, ou de la retraite partielle. Le Chapitre 3 évalue les effets des réformes du régime des retraites sur les transitions du chômage à l’emploi. Les réformes du régime des retraites ont des effets limités sur le retour en emploi des chômeurs, mais elles sont accompagnées par une augmentation des sorties vers l’inactivité, entraînant ainsi une baisse du taux de chômage des travailleurs âgés. Enfin, le Chapitre 4 examine les principaux facteurs des difficultés des seniors à se maintenir en emploi. Il propose également une analyse des opportunités d’emploi des chômeurs âgés. Les résultats montrent que l’état de santé, les incitations économiques et l’âge augmentent la probabilité de quitter son emploi, alors que l’âge diminue les chances de réemploi des travailleurs âgés. Une décomposition à la Oaxaca confirme le rôle déterminant de l’âge dans les différences de durée de chômage entre travailleurs d’âge différent, ce qui est consistent avec des attitudes discriminatoires. / With the global ageing of population and the consequences on public finances sustainability, the labour market of older workers remains a key concern for societies.The aim of this dissertation is to address particular issues on the labour market for older workers.This thesis consists of four chapters.The first two chapters examine the age-earnings trajectories late in working life.We do not find support of a decline of earnings at older ages as the consequence of ageing.The decline of the age-earnings profile observed for older workers at cross-sectional analysis is attributable to cohort effects, job-changing, and partial retirement.Chapter 3 evaluates the effects of French pension reforms on older workers’ transition out of unemployment and into employment. We find that the retirement reforms have limited effects on re-employment, and they increase transitions into inactivity, leading to a decrease of unemployment rate of older workers.Finally,Chapter 4 investigates the factors behind difficulties to remain in employment as workers age. It also evaluates job opportunities of older unemployed workers.The results indicate that the probability of leaving employment increases with economic incentives, ill health and age, while the probability of getting back to employment decreases with age.An Oaxaca decomposition supports the key role of age in the unemployment duration gap between ‘older’ and ‘younger’ workers, which is consistent with age discrimination.

Cette thèse traite deux sujets distincts, les deux représentant des enjeux importants pour un grand nombre de Pays d’Europe Centrale et Orientale (PECO). La première partie porte sur les emprunts en devises étrangères. Plusieurs études antérieures montrent que dans de nombreux PECO, l’endettement en devises étrangères a augmenté de manière considérable avant la crise et est devenu un enjeu majeur pour les entreprises, les ménages et pour la politique budgétaire et monétaire. Pour évaluer les risques associés à l’endettement excessif en devises étrangères, nous étudions la volonté des entreprises d’apparier la composition en devises de leurs actifs et leurs passifs ainsi que leurs incitations à dévier de l’appariement parfait. Nos résultats fournissent des preuves solides à l’appui du rôle de la couverture naturelle. Néanmoins, ce dernier n’est pas le motif principal d’endettement en devise étrangères : le motif de couverture naturelle n’explique qu’environ 10 à 20 pour cent de la dette totale en devises étrangères des entreprises avant et pendant la crise, respectivement. La plus grande partie de la dette en devises étrangères correspondrait, au moins en Hongrie, à des positions de carry trade détenues par des sociétés non financières. La deuxième partie de la thèse est consacrée à l’exploration des liens entre les systèmes socio-fiscaux et l’offre de travail à la marge extensive. Le deuxième chapitre propose une nouvelle stratégie de modélisation de l’offre de travail comme alternative aux deux approches dominantes basées sur le calcul marginal et les modèles d’utilité aléatoire. Finalement, le dernier chapitre utilise ce modèle pour quantifier la part de la différence entre les taux d’activité tchèque et hongrois qui peut être expliquée par les divergences des systèmes d’imposition et de protection sociale. Les estimations donnent des élasticités d’offre de travail similaires, ce qui suggère que les préférences individuelles sont essentiellement identiques dans les deux pays. Nos résultats montrent que la moitié de l’écart entre les taux d’activité s’explique par les différences des systèmes socio-fiscaux. / This thesis deals with two distinct topics, both of them representing central issues for many Central and Eastern European (CEE) countries. The first part of the thesis focuses on foreign currency (FX) lending. Several previous studies point out that in many CEE countries, FX borrowing rose significantly before the crisis and has become a major challenge for firms, households and for fiscal and monetary policy. To evaluate the risks associated with excessive FX indebtedness, we investigate firms’ willingness to match the currency composition of their assets and liabilities and their incentives to deviate from perfect matching. Our results provide strong evidence to support the role of natural hedging, however, it is not the primary motivation for firms to choose foreign currency : it explains only about 10 percent of the overall corporate FX debt during the pre-crisis and 20 percent during the post-crisis periods. Most likely, the largest part of the corporate FX debt, at least in Hungary, corresponds to open carry trade positions held by non-financial corporations. The second part of the thesis is devoted to exploring the links between tax-benefit systems and labour supply at the extensive margin. The second chapter presents an alternative modelling strategy of labour supply to the two dominating approaches based on marginal calculus and on random utility models. Finally, the last chapter uses this model to quantify the difference between the Hungarian and the Czech participation rates that can be attributed to differences in taxation and welfare benefits. We find that the estimated labour supply elasticities for the Czech Republic are very close to the results for Hungary, suggesting that, at least in this dimension, individual preferences are similar in the two countries. Results suggests that about one-half of the total difference in the participation rates can be explained by differences in the tax-benefit systems.

Diese Dissertation umfasst drei Aufsätze zu Mindestlöhnen, zum Arbeitsangebot sowie zu öffentlichen Finanzen. Der Fokus liegt auf den Entwicklungen in Deutschland innerhalb der letzten zwei Jahrzehnte. Der erste Aufsatz untersucht Beschäftigungseffekte des Mindestlohns in einem Modell der Sucharbeitslosigkeit. Das Modell bildet Heterogenität auf Arbeitnehmer- und Arbeitgeberseite ab und schränkt die Richtung der Beschäftigungseffekte ein. Es erlaubt eine unterschiedliche Frequenz der Stellensuche von Beschäftigten und Arbeitslosen und modelliert die Rekrutierungsintensität der Unternehmen. Die Ergebnisse zeigen, dass die Arbeitslosigkeit eine nicht-monotone Funktion des Mindestlohns ist. Die Auswirkungen von verschiedenen Mindestlöhnen unterscheiden sich stark nach Arbeitsmarktsegmenten. Der zweite Aufsatz befasst sich mit Trends im Arbeitsangebotsverhalten in Deutschland. Dazu werden diskrete Wahlmodelle des Arbeitsangebots für die Jahre von 1998 bis 2018 geschätzt. Die implizierten Arbeitsangebotselastizitäten haben in den letzten zwei Jahrzehnten zugenommen, insbesondere für Paare und für alleinstehende Männer. Eine Zerlegungsanalyse zeigt, dass Veränderungen in der Demografie nur eine geringe Rolle bei der Verschiebung der Eigen- und Kreuzlohnelastizitäten von Männern spielen, da der größte Teil der Veränderungen durch Präferenzen oder Arbeitsmarktrestriktionen bedingt ist. Bei Frauen hingegen spielen demografische Veränderungen eine größere Rolle für den Anstieg der Elastizitäten. Der dritte Aufsatz befasst sich mit den deutschen Staatsfinanzen sowie mit Reformen aufgrund der Finanzkrise 2008/2009. Der Aufsatz stellt die makroökonomische Situation und die Entwicklung der Krise in Deutschland dar und beleuchtet die Bedeutung für die öffentlichen Finanzen. In dem Aufsatz werden zudem die Verteilungswirkungen der Reformen im Steuer- und Transfersystem mithilfe von Mikrosimulationen untersucht. / This dissertation consists of three essays on the minimum wage, labour supply, and public finances. The selected essays focus on the German experience and developments over the last two decades. The first essay is an analysis of unemployment effects of the German minimum wage in an empirical equilibrium job search model. The estimated model with worker and firm heterogeneity does not restrict the sign of employment effects a priori; it allows for different job offer arrival rates for the employed and the unemployed and lets firms optimally choose their recruiting intensity. Results show that unemployment is a non-monotonic function of the minimum wage level, and effects differ strongly by labour market segment. The second essay is on the topic of labour supply elasticities in Germany. In order to analyse recent trends in labour supply in Germany, a static discrete choice model of unitary household labour supply is estimated for each year 1998 to 2018. Findings are that own-wage labour supply elasticities implied by the models have increased over the last two decades, especially for couples, and for single males. A decomposition analysis shows that compositional changes in demographics play only a minor role in the shift in males' own- and cross-wage elasticities, since most of the changes in elasticities are driven by preferences or labour market restrictions. For females, changes in composition play a bigger role in the rise of elasticities. The third essay reviews German public finances through the financial crisis 2008/2009. The essay starts with a presentation of the macroeconomic situation and how the crisis unfolded in Germany, before focusing on the situation of the public finances. Finally, the distributional effects of policy responses to the financial crisis are analysed on the individual level using microsimulation.