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

33 Pages Posted: 4 Oct 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)

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Abstract

Comparisons of the effectiveness of two common procedures for Coronary Artery Disease: Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG). 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 alternative specifications.

Keywords: coronary artery disease, moral hazard, smoking

JEL Classification: I10, I12

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. IZA Discussion Paper No. 8492. Available at SSRN: https://ssrn.com/abstract=2505354

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

National Bureau of Economic Research (NBER), NY Office ( email )

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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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Cambridge, MA 02138
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