Publications des chercheurs de PSE

In 2003, a public insurance system was introduced in Chinese rural areas. In the meantime, subjective health status improved. We used a unique household longitudinal survey to analyse how the introduction of an insurance system, known as the New Cooperative Medical Scheme (NCMS), has contributed to the change. This health insurance programme was launched sequentially over counties starting in 2003, and households voluntarily chose whether to participate the programme after its launch by the county. These characteristics make it feasible to disentangle two channels of the influence of the NCMS on self-reported health status. One is the insurance effect of the coverage, which can be estimated by comparing the insured households with non-participants in the villages located in counties that have launched the programme (NCMS counties); the other is the general equilibrium effect that affects all residents in the NCMS counties, and can be estimated by comparing non-participants with the non-exposed households. The longitudinal data also allow us to examine how the effect changes with the duration of households’ subscription to the programme. The empirical findings include: first, a positive extensive margin: an individual feels better about his or her health status when covered by the NCMS. However, there is no intensive margin: there is no additional gain in the self-assessment of health status with the individual’s number of years enrolled in the programme. Second, we find a positive general equilibrium effect of introducing the NCMS programme on non-participants in the NCMS county. This effect accumulates over time.

Ce papier propose d'étendre le modèle de Rothschild et Stiglitz (1976) afin de cerner l'impact de l'assurance santé sur la demande de soins. Alors que le modèle pionnier suppose implicitement l'équivalence entre prix du traitement et inconfort lié à la maladie, nous introduisons la possibilité que le "coût des réparations" diffère du "montant des dommages". Demande d'assurance et demande de soins sont étudiées parallèlement sous information symétrique et asymétrique. La distinction introduite entre prix du traitement et inconfort a trois conséquences majeures. Premièrement, les agents sont prêts à payer plus pour se soigner en présence d'un marché d'assurance santé. Deuxièmement et paradoxalement, la sélection adverse peut conduire le marché à diminuer le prix des soins (par rapport à une situation d'information parfaite). Finalement, notre modèle fait apparaître un phénomène fréquemment observé dans la réalité mais inexistant dans le modèle de Rothschild et Stiglitz : une partie de la population peut choisir de ne pas s'assurer (bien que ne renonçant pas à se soigner en cas de maladie) et ce, même en présence d'une concurrence sur le marché de l'assurance.

How can healthcare access for Chinese migrants be improved? Migrant workers face two types of healthcare-access exclusion in the workplace: a financial one (via income) and a legislative one (from the "hukou"). We use 2006 data from a survey of rural migrant workers conducted in five of the most economically-advanced cities. We estimate a fixed-effect probit model, and control for the non-exogeneity of health insurance. The empirical findings support the hypothesis of a return to the hometown for migrant workers with poor health. Apart from residency permits and income, the social integration of migrant workers is also found to be a decisive factor in healthcare access. Policies tackling migrant healthcare exclusion should thus involve organisations working at the local level, such as residents' committees.

In China, with the economic reforms leading to the raise in agricultural productivity, the rural healthcare organisation has been weakened. In a 1991-2006 database, a decrease in the healthcare demand is observed. If many papers study the effect of the insurance system (NCMS) on the healthcare demand, other factors explaining the healthcare demand have not received much research attention yet. We use a matching and difference in difference model to correct for the selection bias on insurance effect. If the income level and insurance enrollment plays a major role on the healthcare demand, we shed light on the peer effect of the industrialization process and the changes affecting healthcare facilities. In a context of healthcare price widely increasing, the change in villagers working activity leads to an increase in the inequality of healthcare access (due to inequality of wage, mobility, and private insurance). The result is a reduction and sometimes worse, an exclusion from the healthcare access for the poorest. A public policy has to be conducted to support farmers, in particular in areas where a significant part of the village inhabitants have an industrial activity.

Il est difficile de démontrer que les contraintes de crédit sont un frein à l'accès à l'enseignement supérieur : les preuves sont rares et toujours indirectes. Cet article propose une mesure directe de la contrainte de crédit en comparant l'accès à l'université d'étudiants potentiels en Afrique du Sud, selon qu'ils ont accès ou non à un prêt pour couvrir leur frais d'inscription, dans un contexte où ces frais sont élevés. Nous utilisons des données individuelles qui apparient des fichiers d'une institution de crédit aux étudiants (Eduloan) et les fichiers du ministère de l'éducation. L'identification de l'effet d'un prêt sur l'inscription à l'université repose sur la méthode de régression de la discontinuité : on utilise le fait que les prêts sont accordés sur la base d'une valeur seuil d'un score d'historique de crédit. Nous trouvons que les contraintes de crédit sont importantes, puisqu'elles réduisent le taux d'entrée à l'université dans plus de 20 points, dans notre population de candidats à un prêt.

This article sheds light on the important differences in self-declared happiness across countries of similar affluence. It hinges on the different happiness statements of natives and immigrants in a set of European countries to disentangle the influence of objective circumstances versus psychological and cultural factors. The latter turn out to be of non-negligible importance. In some countries, such as France, they are responsible for the best part of the country's unobserved idiosyncratic source of unhappiness. French natives are less happy than other Europeans, whether they live in France or outside. By contrast, immigrants are not less happy in France than they are elsewhere in Europe, but their happiness fall with the passage of time and generations. I show that these gaps in self-declared happiness have a real emotional counterpart and do not boil down to purely nominal differences.

This article sheds light on the important differences in self-declared happiness across countries of similar affluence. It hinges on the different happiness statements of natives and immigrants in a set of European countries to disentangle the influence of objective circumstances versus psychological and cultural factors. The latter turn out to be of non-negligible importance. In some countries, such as France, they are responsible for the best part of the country's unobserved idiosyncratic source of unhappiness. French natives are less happy than other Europeans, whether they live in France or outside. By contrast, immigrants are not less happy in France than they are elsewhere in Europe, but their happiness fall with the passage of time and generations. I show that these gaps in self-declared happiness have a real emotional counterpart and do not boil down to purely nominal differences.

Using comprehensive administrative data on France's single largest financial aid program, this paper provides new evidence on the impact of large-scale need-based grant programs on the college enrollment decisions, persistence, and graduation rates of low-income students. We exploit sharp discontinuities in the grant eligibility formula to identify the impact of aid on student outcomes at different levels of study. We find that the provision of 1,500 euros cash allowances to prospective undergraduate or graduate students increases their college enrollment rates by 5 to 7 percent. Moreover, we show that need-based grants have positive effects on student persistence and degree completion.

Boarding schools substitute school to home, but little is known on the effects this substitution produces on students. We present results of an experiment in which seats in a boarding school for disadvantaged students were randomly allocated. Boarders enjoy better studying conditions than control students. However, they start outperforming control students in mathematics only two years after admission, and this effect mostly comes from strong students. Boarders initially experience lower levels of well-being but then adjust. This suggests that substituting school to home is disruptive: only strong students benefit from the school, once they have adapted to their new environment.

National financial aid programs for disadvantaged students cover a significant fraction of college students and represent a non-negligible component of the public budget. These programs often have relatively weak academic requirements for renewal, potentially leading to moral hazard and efficiency losses. Using a reform in the Spanish need-based grant program in higher education, this paper tests the causal effect of receiving the same amount of grant under different intensities of academic requirements on student performance, degree completion, and student dropout. I use administrative micro-data on the universe of applicants to the grant in a large university. Exploiting sharp discontinuities in the grant eligibility formula, I find strong positive effects of being eligible for a grant on student performance when combined with demanding academic requirements, while there are no effects on student dropout. Students improve their final exam attendance rate, their average GPA in final exams, and their probability of completing the degree. They also reduce the fraction of subjects that they have to retake. The grant has no effects on student performance, degree completion, and student dropout when academic requirements are comparable to those set out by national need-based student aid programs around the world. These results suggest that academic requirements in the context of higher education financial aid can be an effective tool to help overcome moral hazard concerns and improve aid effectiveness.