We study the question of whether women, on average, pay a price premium — a so-called “pink tax” — for the products they buy. A particular concern facing policy makers is whether such differences are a form of gender based price discrimination. Using scanner data, we find that averaged across the entire retail grocery consumption basket, women pay 4% more per unit for goods in the same product-by-location market as do men. This price differential is generated by a 15% higher average per unit price paid by women on explicitly gendered products, like personal care items, as well as a 3.8% higher average per unit price paid by women on ungendered products, like packaged food items. Higher prices paid by women could be the result of differences in demand elasticity, competitive structure, or sorting into goods with differing marginal costs. To disentangle these mechanisms, we estimate demand differences between men and women and structurally decompose price differences into markups and marginal costs. We find that women are, on average, more price elastic consumers than men, suggesting that as a consumer base women are not likely to be charged higher markups under price discrimination. Overall, we find that the pink tax is not sustained by higher markups charged to women, but by women sorting into goods with higher marginal costs and lower markups.
Works in Progress
This paper estimates the impact of social health insurance on financial risk by utilizing data from a natural experiment created by the phased roll-out of a social health insurance program for the poor in India. We estimate the distributional impact of insurance on of out-of-pocket costs and incorporate these results with a stylized expected utility model to compute associated welfare effects. We adjust the standard model, accounting for conditions of developing countries by incorporating consumption floors, informal borrowing, and asset selling which allow us to separate the value of financial risk reduction from consumption smoothing and asset protection. Results show that insurance reduces out-of-pocket costs, particularly in higher quantiles of the distribution. We find reductions in the frequency and amount of money borrowed for health reasons. Finally, we find that the value of financial risk reduction outweighs total per household costs of the insurance program by two to five times.
Policymakers are increasingly interested in reducing healthcare costs and inefficiencies through innovative payment strategies. These strategies may have heterogeneous impacts across geographic areas, potentially reducing or exacerbating geographic variation in healthcare spending. In this paper, we exploit a major payment reform for home health care to examine whether reductions in reimbursement lead to differential changes in treatment intensity and provider costs depending on the level of competition in a market. Using Medicare claims, we find that while providers in more competitive markets had higher average costs in the pre-reform period, these markets experienced larger proportional reductions in treatment intensity and costs after the reform relative to less competitive markets. This led to a convergence in spending across geographic areas. We find that much of the reduction in provider costs is driven by greater exit of “high-cost” providers in more competitive markets.
The high prevalence of coronary heart disease and dramatic growth of cardiac interventions in India motivate an evaluation of the appropriateness of coronary revascularisation procedures in India. Although, appropriate-use criteria (AUC) have been used to analyse the appropriateness of cardiovascular care in the USA, they are yet to be applied to care in India. In our study, we apply AUC to cardiac care in Karnataka, India, compare our results to international applications of AUC, and suggest ways to improve the appropriateness of care in India.