Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking

32 Pages Posted: 18 Aug 2014

See all articles by Jesse Margolis

Jesse Margolis

New York University (NYU) - Robert F. Wagner Graduate School of Public Service; CUNY - The Graduate Center

Jason Hockenberry

Emory University

Michael Grossman

National Bureau of Economic Research (NBER), NY Office; CUNY The Graduate Center - Department of Economics

Shin-Yi Chou

Lehigh University - Department of Economics; National Bureau of Economic Research (NBER)

Multiple version iconThere are 2 versions of this paper

Date Written: August 2014

Abstract

Over the last several decades, numerous medical studies have compared the effectiveness of two common procedures for Coronary Artery Disease: Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG). Most evidence indicates that CABG - the more invasive procedure - leads to superior long term outcomes for otherwise similar patients, though there is little consensus as to why. In this article, we propose a novel explanation: patient offsetting behavior. We hypothesize that patients who undergo the more invasive procedure, CABG, are more likely to improve their behavior - eating, exercise, smoking, and drinking - in a way that increases longevity. To test our hypothesis, we use Medicare records linked to the National Health Interview Survey to study one such behavior: smoking. We find that CABG patients are 12 percentage points more likely to quit smoking in the one-year period immediately surrounding their procedure than PCI patients, a result that is robust to numerous alternative specifications.

Suggested Citation

Margolis, Jesse and Hockenberry, Jason and Grossman, Michael and Chou, Shin-Yi, Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking (August 2014). NBER Working Paper No. w20373. Available at SSRN: https://ssrn.com/abstract=2482135

Jesse Margolis (Contact Author)

New York University (NYU) - Robert F. Wagner Graduate School of Public Service ( email )

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CUNY - The Graduate Center ( email )

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Jason Hockenberry

Emory University ( email )

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Michael Grossman

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HOME PAGE: http://mgrossman.ws.gc.cuny.edu

Shin-Yi Chou

Lehigh University - Department of Economics ( email )

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United States

National Bureau of Economic Research (NBER) ( email )

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