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Does Public Health Insurance Reduce Labor Market Flexibility or Encourage the Underground Economy? Evidence from Spain and the United States

In: Social Protection versus Economic Flexibility: Is There a Trade-Off?

Author

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  • Sara de la Rica
  • Thomas Lemieux
Abstract
This paper compares the labor market implications of the health insurance system in Spain and in the United States. While most health insurance is privately provided to workers (by employers) in the United States, Spanish workers obtain health insurance coverage from the public social security system. The Spanish system is financed by a payroll (social security) tax shared between employers and employees. There is clear evidence, however, of widespread non-compliance with the social security tax. This paper empirically compares the incidence of health insurance coverage among U.S. workers to the pattern of compliance with the social security tax among Spanish workers. The main finding of this paper is that these two patterns are very similar. They both depend on the same supply and demand factors, which is consistent with basic economic models of private provision of benefits and of tax compliance. However, one important difference between the two systems is that in Spain, unlike the United States, essentially all heads of household work in the covered sector and thus have a full access to public health care for themselves and for their dependents.
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Suggested Citation

  • Sara de la Rica & Thomas Lemieux, 1994. "Does Public Health Insurance Reduce Labor Market Flexibility or Encourage the Underground Economy? Evidence from Spain and the United States," NBER Chapters, in: Social Protection versus Economic Flexibility: Is There a Trade-Off?, pages 265-300, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberch:11261
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    References listed on IDEAS

    as
    1. Fortin, B. & Lemieux, T. & Frechette, P., 1990. "An Empirical Model Of Labor Supply In The Underground Economy.," Papers 9005, Laval - Recherche en Politique Economique.
    2. Diamond, Peter, 1992. "Organizing the Health Insurance Market," Econometrica, Econometric Society, vol. 60(6), pages 1233-1254, November.
    3. Danzon, Patricia M., 1990. "Mandated Employment-Based Health Insurance: Incidence and Efficiency Effects," Working Papers 60, The University of Chicago Booth School of Business, George J. Stigler Center for the Study of the Economy and the State.
    4. Jonathan Gruber & Alan B. Krueger, 1991. "The Incidence of Mandated Employer-Provided Insurance: Lessons from Workers' Compensation Insurance," NBER Chapters, in: Tax Policy and the Economy, Volume 5, pages 111-144, National Bureau of Economic Research, Inc.
    5. Stigler, George J & Becker, Gary S, 1977. "De Gustibus Non Est Disputandum," American Economic Review, American Economic Association, vol. 67(2), pages 76-90, March.
    6. Frank A. Cowell, 1990. "Cheating the Government: The Economics of Evasion," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262532484, April.
    7. Summers, Lawrence H, 1989. "Some Simple Economics of Mandated Benefits," American Economic Review, American Economic Association, vol. 79(2), pages 177-183, May.
    8. repec:fth:prinin:279 is not listed on IDEAS
    9. Jonathan Gruber & Alan Krueger, 1990. "The Incidence of Mandated Employer-Provided Insurance: Lessons from Workers' Compensations Insurance," Working Papers 659, Princeton University, Department of Economics, Industrial Relations Section..
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    Cited by:

    1. Auerbach, Paula & Genoni, María Eugenia & Pagés, Carmen, 2005. "Social Security Coverage and the Labor Market in Developing Countries," IDB Publications (Working Papers) 1111, Inter-American Development Bank.
    2. Card, David & de la Rica, Sara, 2004. "The Effect of Firm-Level Contracts on the Structure of Wages: Evidence from Matched Employer-Employee Data," IZA Discussion Papers 1421, Institute of Labor Economics (IZA).
    3. Mary C. King, 2002. "Strong Families or Patriarchal Economies? Southern European Labor Markets and Welfare in Comparative Perspective," EUI-RSCAS Working Papers 14, European University Institute (EUI), Robert Schuman Centre of Advanced Studies (RSCAS).
    4. Cutler, David M. & Knaul, Felicia & Lozano, Rafael & Mendez, Oscar & Zurita, Beatriz, 2002. "Financial crisis, health outcomes and ageing: Mexico in the 1980s and 1990s," Journal of Public Economics, Elsevier, vol. 84(2), pages 279-303, May.
    5. Brigitte C. Madrian, 2005. "The U.S. health care system and labor markets," Conference Series ; [Proceedings], Federal Reserve Bank of Boston, vol. 50(Jun), pages 137-163.
    6. Mary King, 2002. "Strong Families or Patriarchal Economies? ""Familial"" Labor Markets and Welfare States in Comparative Perspective," LIS Working papers 301, LIS Cross-National Data Center in Luxembourg.
    7. Paula Auerbach & María Eugenia Genoni & Carmen Pagés-Serra, 2005. "Cobertura del sistema de seguridad social y el mercado laboral en países en desarrollo," Research Department Publications 4422, Inter-American Development Bank, Research Department.
    8. Amuedo Dorantes, Catalina & De la Rica Goiricelaya, Sara, 2005. "Immigrants Responsiveness to Labor Market Conditions," DFAEII Working Papers 1988-088X, University of the Basque Country - Department of Foundations of Economic Analysis II.
    9. repec:eee:labchp:v:3:y:1999:i:pc:p:3309-3416 is not listed on IDEAS
    10. Amuedo-Dorantes, Catalina & de la Rica, Sara, 2005. "Immigrants' Responsiveness to Labor Market Conditions and Its Implications on Regional Disparities: Evidence from Spain," IZA Discussion Papers 1557, Institute of Labor Economics (IZA).
    11. Roberto Gallardo del Ángel, 2009. "A Microeconometric Analysis on the Pension Reforms in Argentina, Bolivia, Mexico and Uruguay," Economía: teoría y práctica, Universidad Autónoma Metropolitana, México, vol. 30(1), pages 83-114, Enero-Jun.
    12. Card, David & de la Rica, Sara, 2004. "The Effect of Firm-Level Contracts on the Structure of Wages: Evidence from Matched Employer-Employee Data," IZA Discussion Papers 1421, Institute of Labor Economics (IZA).
    13. Mendez, Oscar & Cutler, David & Knaul, Felicia & Lozano, Rafael & Zurita, Beatriz, 2002. "Financial Crisis, Health Outcomes, and Aging: Mexico in the 1980s and 1990s," Scholarly Articles 2707939, Harvard University Department of Economics.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J3 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs

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