Journal of Public Economics 2023年第1期
Volume 217，January 2023


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1.Primary care providers’ influence on opioid use and its adverse consequences
初级保健提供者对阿片类药物使用的影响及其不良后果
Sarah Eichmeyer, Jonathan Zhang
Primary care is the most frequently utilized health service and is the source of nearly half of all opioids prescribed in the United States. This paper studies the impact of exposure to high prescribing primary care providers (PCP) on opioid use, opioid use disorder, and mental health. Using electronic health records, we exploit within-facility quasi-random assignment of providers, who differ in their opioid prescribing tendency, to 650,000 new patients enrolling in care with the Veterans Health Administration. We find that assignment to a PCP who prescribes opioids at a 2.54 percentage point (pp) higher rate (equivalent to the average difference between a 90th and 10th percentile prescriber within a facility) increases the probability of long-term opioid use by 20% (or 0.43 pp) and development of opioid use disorder by 4% (or 0.035 pp). Veterans’ mental health deteriorates: the three-year likelihood of a depression diagnosis increases by 1.3% (or 0.31 pp). We find that PCPs with more cautious prescribing behavior rely more on non-opioid pain management and adhere more to clinical recommendations on naloxone distribution.
初级保健是使用最频繁的卫生服务，是美国处方的所有阿片类药物中近一半的来源。本文研究了接触高处方初级保健提供者(PCP)对阿片类药物使用、阿片类药物使用障碍和心理健康的影响。利用电子健康记录，我们利用机构内的提供者准随机分配(他们的阿片类药物处方倾向不同)来照顾65万名在退伍军人健康管理局(Veterans health Administration)登记的新患者。我们发现，如果一个PCP开出的阿片类药物处方率高出2.54个百分点(相当于一个机构内第90和第10百分位处方者的平均差异)，那么长期使用阿片类药物的概率将增加20%(或0.43 pp)，发生阿片类药物使用障碍的概率将增加4%(或0.035 pp)。退伍军人的心理健康状况恶化:三年内被诊断为抑郁症的可能性增加了1.3%(或0.31 pp)。我们发现，处方行为更谨慎的pcp更依赖于非阿片类镇痛管理，并更遵守纳洛酮分配的临床建议。



2.Majority choice of taxation and redistribution in a federation
联邦中征税和再分配的多数人选择
Stephen Calabrese, Dennis Epple, Richard Romano
To study redistribution and taxation in a federation, we provide a model with a central government and multiple local governments, the former with power to levy an income tax for redistribution, and the latter choosing a local income tax, property tax, lump-sum tax or subsidy, and a local public good. Policy is set by majority choice at each tier of government by households that differ by income and by ability to move among local jurisdictions. We provide sufficient conditions for existence of equilibrium and examine its properties. Central findings are federal income distribution, little local redistribution, and local preference for property taxation over income taxation to fund local public goods.
为了研究联邦中的再分配和税收，我们提供了一个由中央政府和多个地方政府组成的模型，中央政府有权征收所得税进行再分配，而地方政府可以选择征收地方所得税、财产税、一次性税收或补贴，以及地方公共产品。政策是由各级政府的多数人选择制定的，由收入和在地方司法管辖区之间流动能力不同的家庭制定的。我们给出了平衡存在的充分条件，并考察了它的性质。主要发现是联邦收入分配，地方再分配很少，地方在为地方公共产品提供资金时对财产税的偏好高于所得税。



3.Do environmental markets cause environmental injustice? Evidence from California’s carbon market
环境市场会导致环境不公吗?来自加州碳市场的证据
Danae Hernandez-Cortes, Kyle C. Meng
Market-based environmental policies are widely adopted on the basis of allocative efficiency. However, there is growing concern that market-induced spatial reallocation of pollution could widen existing pollution concentration gaps between disadvantaged and other communities. We examine how this “environmental justice” (EJ) gap changed following the 2013 introduction of California’s carbon market, the world’s second largest and the most subjected to EJ critiques. We estimate that the program lowered GHG, PM2.5, PM10, and NOx emissions by 3–9% annually between 2012–2017 for sample industrial facilities regulated only by the carbon market. Using a pollution dispersal model to characterize resulting spatial changes in pollution concentrations, we find the program caused EJ gaps in PM2.5, PM10, and NOx from these facilities to narrow by 6–10% annually. We demonstrate that explicit modeling of pollution dispersal is critical for detecting these results.
以市场为基础的环境政策在配置效率的基础上得到广泛采用。然而，越来越多的人担心，市场导致的污染空间重新分配可能会扩大弱势社区和其他社区之间现有的污染浓度差距。我们研究了2013年加州碳市场引入后，这种“环境正义”(EJ)差距是如何变化的。加州是世界上第二大碳市场，也是受到EJ批评最多的碳市场。我们估计，对于仅受碳市场监管的样本工业设施，该项目在2012-2017年期间每年将温室气体、PM2.5、PM10和氮氧化物排放降低了3-9%。使用污染扩散模型来描述污染浓度的空间变化，我们发现该计划导致这些设施的PM2.5、PM10和NOx的EJ差距每年缩小6-10%。我们证明，污染扩散的显式建模对于检测这些结果至关重要。



4.Combining rules and discretion in economic development policy: Evidence on the impacts of the California Competes Tax Credit
结合规则和自由裁量权的经济发展政策:加州竞争税收抵免的影响的证据
Matthew Freedman, Shantanu Khanna, David Neumark
We evaluate the effects of one of a new generation of economic development programs, the California Competes Tax Credit (CCTC), on local job creation. Incorporating perceived best practices from previous initiatives, the CCTC combines explicit eligibility thresholds with some discretion on the part of program officials to select tax credit recipients. The structure and implementation of the program facilitates rigorous evaluation. We exploit detailed data on accepted and rejected applicants to the CCTC, including information on the scoring of applicants with regard to program goals as well as on funding decisions, together with restricted-access American Community Survey (ACS) data on local economic conditions. Using a difference-in-differences approach, we find that each CCTC-incentivized job in a census tract increases the number of individuals working in that tract by close to 3 – a significant local multiplier. Local multipliers are larger for non-manufacturing awards than for manufacturing awards. CCTC awards increase employment among workers across socioeconomic groups and in more- as well as less-advantaged neighborhoods, but have limited impact on residents of affected communities. We validate our empirical strategy and confirm our core results using an alternative dataset and recently developed difference-in-differences methods that correct for potential biases generated by variation in treatment timing and treatment effect heterogeneity.
我们评估了新一代经济发展项目之一——加州竞争税收抵免(CCTC)在当地创造就业机会方面的影响。CCTC结合了从以前的倡议中获得的最佳实践，将明确的资格门槛与项目官员的一些自由裁量权结合起来，以选择税收抵免受益人。该计划的结构和实施有助于严格的评估。我们利用CCTC接受和拒绝申请人的详细数据，包括申请人在项目目标和资金决策方面的评分信息，以及有关当地经济状况的美国社区调查(ACS)的限制访问数据。使用差异中的差异方法，我们发现在人口普查区域内，每一个cctc激励的工作都会使该区域内的工作人数增加近3——这是一个显著的当地乘数。非制造业奖项的局部乘数大于制造业奖项。CCTC奖励增加了社会经济群体和较弱势社区的工人就业，但对受影响社区居民的影响有限。我们验证了我们的经验策略，并使用替代数据集和最近开发的差异中差异方法确认了我们的核心结果，这些方法纠正了因治疗时间和治疗效果异质性的变化而产生的潜在偏差。



5.Violence-induced migration and peer effects in academic performance
暴力导致的移民与学业成绩的同伴效应
María Padilla-Romo, Cecilia Peluffo
We document that local violence generates spillover effects beyond areas where violence takes place, via out-migration from violence-affected areas and peer exposure to violence. In the context of the Mexican war on drugs, we use violence-induced student migration as an exogenous source of variation in peer exposure to violence to estimate its effects on the academic performance of non-moving students in areas not directly affected by violence. Our results show that municipalities that face more violence experience higher rates of student out-migration. In receiving schools in areas not directly affected by violence, adding a new peer who was exposed to local violence to a class of 20 students decreases incumbents’ academic performance by 2 percent of a standard deviation. Negative effects are more pronounced among girls and high-achieving students.
我们发现，通过从受暴力影响的地区向外迁移和同伴接触暴力，地方暴力会产生溢出效应，超出暴力发生地。在墨西哥禁毒战争的背景下，我们使用暴力引发的学生移民作为同伴暴力暴露的外生变化源，来估计它对未直接受暴力影响地区的非流动学生的学习成绩的影响。我们的研究结果表明，面对更多暴力的城市，学生外流的比例更高。在接受没有直接受暴力影响的地区的学校，在一个由20名学生组成的班级中增加一个接触过当地暴力的新同学，会使现任学生的学业成绩下降2%的标准偏差。负面影响在女孩和优等生中更为明显。



6.Offshore tax evasion and wealth inequality: Evidence from a tax amnesty in the Netherlands
离岸逃税和财富不平等:来自荷兰税收大赦的证据
Wouter Leenders, Arjan Lejour, Simon Rabaté, Maarten van ’t Riet
Exploiting unique datasets covering over 29,000 tax evaders in the Netherlands, we investigate the distribution of tax evasion and its implications for the measurement of wealth inequality. Tax evasion is concentrated at the top of the wealth distribution with over 10% of the wealthiest 0.01% of households – the “super rich” – evading taxes. At the top, households evade around 8% of their true tax liability. The “merely rich” (P90-P99.9) own 67% of hidden wealth, while the “super rich” account for only 7%. Consequently, the correction for offshore wealth has a modest effect on top wealth shares. We describe a number of explanations for the distribution of tax evasion by Dutch households: low-cost tax evasion opportunities in neighbouring countries for the “merely rich”, sophisticated forms of tax evasion for, low effective tax rates on and migration to low tax jurisdictions by the “super rich”. Taken together, these explanations suggest that the distribution of tax evasion strongly depends on a country’s geographical and institutional settings.
利用涵盖荷兰29,000多名逃税者的独特数据集，我们调查了逃税的分布及其对衡量财富不平等的影响。逃税集中在财富分配的顶端，最富有的0.01%的家庭(“超级富豪”)中有超过10%的人在逃税。在顶层，家庭逃避了他们真实纳税义务的8%左右。“普通富人”(P90-P99.9)拥有67%的隐藏财富，而“超级富豪”只占7%。因此，离岸财富的调整对顶级财富份额的影响不大。我们描述了荷兰家庭逃税分布的一些解释:“仅仅是富人”在邻国的低成本逃税机会，对“超级富人”的复杂逃税形式，对“超级富人”的低有效税率和移民到低税收管辖区。综上所述，这些解释表明，逃税的分布在很大程度上取决于一个国家的地理和制度背景。



7.When (and why) providers do not respond to changes in reimbursement rates
何时(以及为什么)医疗机构对报销率的变化不予回应
Marcus Dillender, Lu Jinks, Anthony T. Lo Sasso
Policies to reduce health care payments can lead to health care access issues if providers reduce their supply in response to reimbursement rate reductions. We examine the impact of a policy that reduced reimbursement rates by 30% in a workers’ compensation insurance system that provided generous reimbursement rates relative to other payers even after the rate reduction. The results suggest that providers’ supply is inelastic at the part of the reimbursement distribution that we study. Our estimates indicate that the policy reduced annual workers’ compensation medical costs by over $400 million without affecting injured workers’ health care utilization or health.
如果提供者为应对报销率的降低而减少供应，减少医疗保健付款的政策可能导致医疗保健获得问题。我们研究了一项政策的影响，该政策将报销率降低了30%，在一个工人赔偿保险系统中，即使在费率降低后，相对于其他支付者，该系统仍提供了慷慨的报销率。结果表明，在我们研究的报销分配部分，提供者的供给是无弹性的。我们的估计表明，该政策在不影响受伤工人的医疗保健利用或健康的情况下，每年减少了4亿多美元的工伤医疗补偿费用。




——更多动态，请持续关注gzh：理想主义的百年孤独