Hello! I am an Assistant Professor at the Toulouse School of Economics. I received my PhD in Economics at Harvard University. During my doctoral studies, I was an NBER Aging and Health Fellow and a National Science Foundation Fellow.
My research studies the optimal design of health care policy, with two main substantive areas: public health insurance systems and pharmaceutical payment policy. I am interested in policy designs that (1) advance health equity, (2) minimize risk for the most disadvantaged individuals, and (3) incentivize socially valuable investments. My work falls at the intersection of health economics and public finance, combining methods from optimal tax theory with traditional cost-effectiveness analysis in health economics.
Primary Field: Health Economics
Secondary Fields: Public Finance, Contract Theory
My CV can be found here.
Publications
Working Papers
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The Risk Protection Value of Moral Hazard
Abstract
Health insurance lowers the out-of-pocket price of healthcare, and it is well-established that this leads to higher utilization of care. This type of “moral hazard” is typically viewed as a social cost of insurance. Within a standard model, we show that there are two important ways in which the consumer’s ability to change her behavior in response to insurance can play a central role in the ability of insurance to protect her from risk. These are (i) by allowing optimal exploitation of real income gained in bad states, and (ii) by enabling more resources to be shifted to bad states than otherwise could be. We provide a theoretical characterization of these cases and quantify their importance empirically. Under standard parameterizations of demand for healthcare and health insurance, estimates in the literature imply that moral hazard accounts for as much as half of the total value of risk protection derived from insurance. Preventing consumers from changing their behavior in response to insurance would lower costs, but also result in a major loss of risk protection, on-net reducing consumer welfare in the population we study. Our results suggest that under-utilization of healthcare may thus be an equally important threat to welfare as over-utilization.
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Income, Health, and the Social Value of Transfers
Abstract
The central trade-off in designing public transfer programs lies in balancing the social value of a transfer against its fiscal and behavioral costs. While existing work has focused extensively on estimating these costs, much less is known about how society values transfers to individuals with different characteristics. Yet preferences over the allocation of transfers across potential recipients are measurable and well defined. This paper estimates these preferences. We field a large-scale survey experiment in which respondents allocate resources across potential recipients who vary in their level of income, age, health, and gender. Using both incentivized and hypothetical tasks, we estimate a discrete choice model that recovers the social marginal utility of income conditional on recipient characteristics. Preferences display systematic structure: individuals with low income or poor health are consistently favored, while age plays a modest role. We embed these estimates in the Marginal Value of Public Funds framework to assess the welfare implications of real-world transfer policies with limited fiscal spillovers.
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Healthcare Demand Among Low-Income Individuals
Abstract
Low-income individuals are typically the most price sensitive segment of the market, but this is not true in the market for health care. Using data from the RAND and Oregon experiments, I show that low-income individuals are less likely to participate in health care markets, relative to higher income counterparts, attenuating the average demand elasticity for this group. The key insight is that income effects may exclude low-income individuals from participating because, when marginal utility of consumption is high, forgoing non-medical consumption becomes too costly. These findings have implications for policy design and model specification.
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Health Insurance for Redistribution
Abstract
The paper studies the role of health insurance for health equity. We consider a social planner that cares about health inequality in addition to income inequality. Focusing on a restricted policy space that offers different health care subsidies for the rich and poor, we derive sufficient statistics formulas for optimal policy, which depends on three objects: demand elasticities of medical spending by income, the joint distribution of health, income, and medical spending, and social preferences. We calibrate the joint distribution of health, income and medical spending using the Medical Expenditure Panel Survey, and revisit the RAND Health Insurance experiment to recover demand elasticities by income. Then, we simulate the optimal joint health insurance policy and tax schedule using social welfare weights that approximate Utilitarian and Rawlsian welfare objectives over health and income. An egalitarian planner chooses Medicare for all, and a Rawlsian planner chooses a public insurance policy that is much more generous than current Medicaid: full coverage for individuals below 300% of the Federal Poverty Line, and partial coinsurance for the rest.
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Optimal Contracting for Low-Value Care
Abstract
A significant share of health care spending comes from low-value, or minimal benefit, services. Why do countries pay for these services and what can optimal contracts do to contain this type of spending? I study optimal contracting for ‘flat of the curve’ medicine in a principal agent framework with altruistic providers. I find that altruism leads to inefficient overprovision of care when governments use cost-based reimbursement, and that treatment caps optimally contain excess spending. Global budgets, as in the U.K., achieve first best outcomes when perfect risk adjustment is possible, or when providers are substantially altruistic.
Selected Work in Progress
- The Redistributive Value of Behavioral Responses to Taxation
- Redesigning Payment Policy for Physician Administered Drugs
- Income Loss Following Sickness
- A Prescription for Manipulation
Teaching
Current Courses
- Health Economics (PhD level), Toulouse School of Economics
- Public Economics (PhD level), Toulouse School of Economics
Office Hours
By appointment! Please sign up for an office hours slot and come introduce yourself. Always happy to discuss research ideas (in health, contracts, or beyond), graduate school life, welfare functions, or anything you would like to talk about.
To make an appointment, please use this link.
Formerly Taught Courses
- EC 2010B General Equilibrium and Contract Theory (Teaching Fellow), Harvard University — Class Materials
Contact
Email: angelique.acquatella@tse-fr.eu
Mailing Address:
Toulouse School of Economics
1 Esplanade de l'Université
31080 Toulouse Cedex 06
Office T683
Toulouse, France