THREE HEALTH ECONOMIC CONSEQUENCES OF CHRONIC ILLNESS: INSURANCE-RELATED JOB LOCK, INADEQUATE INSURANCE COVERAGE, AND HEALTH CARE PROVIDER'S TREATMENT COSTS

My dissertation examines three health economic consequences of chronic illnesses: insurance-related job lock, inadequate insurance coverage, and health care provider's treatment costs. Workers who have health insurance at their current job might be less likely to change jobs if doing so would mean a loss or reduction in coverage, resulting in insurance-related "job lock". Chronically ill workers or workers who have family members with a chronic illness are especially susceptible to job lock. They may face high medical bills and place a high value on retaining coverage that they may lose by changing employers. My results indicate evidence for job lock among healthy and chronically ill men and chronically ill single women. For healthy men with a chronically ill family member who relies on the men's insurance, the conditional probability of leaving a job was reduced by 36%, and for chronically ill men who rely on their employer for insurance, the conditional probability was reduced by 54.5%. For ill single women, the conditional probability was reduced by 72%.; Although seriously or chronically ill individuals may need protection against financially burdensome medical expenses, they might have difficulty obtaining or maintaining adequate insurance coverage due to the medical underwriting practices of some insurers. Using data from both healthy and chronically ill individuals, I examined the effect that the presence of a chronic illness on the probability of having adequate insurance, underinsurance, and uninsurance. I found evidence that the presence of a chronic illness decreased the probability of having adequate insurance, particularly for single individuals.; Factors that impede access to health care for chronically ill individuals, such as inadequate insurance, could potentially increase health care costs if they prevent appropriate disease management. To examine the impact of patterns of health care use by chronically ill individuals on health care provider treatment costs, I estimated the annual health care costs accrued inner city asthma patients. Among 1,205 patients the average cost of an outpatient visit for asthma was {dollar}188 but was {dollar}3,812 for a hospital admission. The results highlight the importance of access to preventative care if such care can reduce hospital admissions.