Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120

 

Presentation

International Competition and the Demand for Health Insurance in the US: Evidence from the Texas-Mexico Border Region

Authors: H. Shelton Brown (University of Texas School of Public Health); Jose A. Pagan (University of Texas-Pan American); Elena Bastida (University of Texas-Pan American)

Presenter: H. Shelton Brown (University of Texas School of Public Health)

Discussant: John Bridges (Johns Hopkins Bloomberg School of Public Health)

Session: Competition

Room: Seminar C

When: Tuesday 3:15 p.m. - 4:45 p.m.

Conventional economic explanations for uninsurance should apply to all geographic regions in the United States. However, the border states of California, Arizona, New Mexico and Texas have the highest rates of uninsurance in the US, accounting for over 30 percent of the total US uninsured population. We use survey data from the fourth wave of the Border Epidemiologic Study on Aging (BESA), a survey from a predominantly Mexican American region of South Texas, to analyze how health insurance coverage in the US is related to the use of health care services in Mexico. BESA includes data on the use of health care services in the US and Mexico. We estimate probit models to investigate the association between having insurance coverage in the US and having a regular doctor in Mexico. Separate models are estimated for having private insurance, Medicare Part B insurance, and any type of insurance. We deal with the endogeneity, due to reverse causality, of having a regular doctor in Mexico by using instrumental variables in a bivariate probit model. The instruments are dental care utilization in Mexico and a variable which measures frequently visiting Mexico. The results show that competition from Mexico lowers the demand for health insurance coverage in the US side of the border.