Bismarck's Health Insurance and the Mortality Decline. Issue 5 (10th October 2019)

• Record Type: Journal Article
• Authors: Bauernschuster, Stefan; Driva, Anastasia; Hornung, Erik
• Is Part Of: Journal of the European Economic Association. Volume 18:Issue 5(2020)
• Page Start: 2561
• Page End: 2607
• Publication Date: 2019-10-10
• Subjects: Economics -- Periodicals; Économie politique -- Périodiques; Science économique; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 330
• DOI: 10.1093/jeea/jvz052
• Languages: English
• ISSNs: 1542-4766

Abstract

Abstract: We study the impact of social health insurance on mortality. Using the introduction of compulsory health insurance in the German Empire in 1884 as a natural experiment, we estimate difference-in-differences and regional fixed effects models exploiting variation in eligibility for insurance across occupations. Our findings suggest that Bismarck's health insurance generated a significant mortality reduction. Despite the absence of antibiotics and most vaccines, we find the results to be largely driven by a decline of deaths from infectious diseases. Further evidence suggests that statutory access to well-trained doctors was an elementary channel. This finding may be explained by insurance fund physicians transmitting new knowledge on infectious disease prevention.