JBNST - Vol. 238/5 - 2018

Long waiting times are a common feature and a major concern in many public health care systems. They are often characterized as inefficient because they are a burden to patients without generating any gains for providers. There is an ongoing debate in Germany regarding the preferential treatment given to private health insurance (PHI) holders while statutory health insurance (SHI) holders face continuously increasing waiting times. In order to tackle this problem in the outpatient sector, Germany initiated a reform in 2015 which was aimed at providing SHI holders with appointments within an acceptable time frame. We exploit longitudinal experimental data to examine waiting times for six elective outpatient treatments in Germany for PHI and SHI holders before and after the reform. We find a considerable difference in waiting times favoring private patients. For SHI holders, waiting times remained stable over time (27.5 days in 2014, 30.7 days in 2016, ? 3.2 days, p-value = 0.889) while PHI holders experienced a significant improvement (13.5 days in 2014; 7.8 days in 2016; ? 5.7 days, p-value = 0.002). The results indicate that even after the reform there is still an unequal access to elective outpatient treatment depending on the patient’s insurance status.

This paper empirically investigates biased beliefs about the risks of smoking. First, it confirms the established tendency of people to overestimate the lifetime risk of a smoker to contract lung cancer. In this paper’s survey, almost half of all respondents overestimate this risk. However, 80% underestimate lung cancer deadliness. In reality, less than one in five patients survive five years after a lung cancer diagnosis. Due to the broad underestimation of the lung cancer deadliness, the lifetime risk of a smoker to die of lung cancer is underestimated by almost half of all respondents. Smokers who do not plan to quit are significantly more likely to underestimate this overall mortality risk.

The Bayesian structural time series model, used in conjunction with a state–space model, is a novel means of exploring the causal impact of a policy intervention. It extends the widely used difference–in–differences approach to the time series setting and enables several control series to be used to construct the counterfactual. This paper highlights the benefits of using this methodology to estimate the effectiveness of an absolute ban on smoking in public places, compared with a partial ban. In January 2006, the Spanish government enacted a tobacco control law which banned smoking in bars and restaurants, with exceptions depending on the floor space of the premises. In January 2011, further legislation in this area was adopted, removing these exceptions. The data source used for our study was the monthly legal sales of cigarettes in Spain from January 2000 to December 2014. The potential control series were the monthly tourist arrivals from the United Kingdom, the total number of visitors from France, the unemployment rate and the average price of cigarettes. Analysis of the state– space model leads us to conclude that the partial ban was not effective in reducing the tobacco sold in Spain, but that the total ban contributed significantly to reducing cigarette consumption.

Starting in 2004/2005, the German state Baden-Wurttemberg reduced academic track duration from nine to eight years, leaving cumulative instruction time mostly unchanged. I use this change in schooling policy to identify the effect of increased schooling intensity on students’ internalizing mental health problems and perceived stress. Using data on 2306 students from the Additional Study Baden-Wurttemberg of the National Educational Panel Study (NEPS), estimates show strong negative effects on internalizing mental health problems for girls and an increase in stress for both genders.