The efficiency of publicly-subsidized, privately-provisioned social insurance programs depends on the interaction between strategic insurers and the subsidy mechanism. We study this interaction in the context of Medicare's prescription drug coverage program. We find that the observed mechanism is successful in keeping "raise-the-subsidy" incentives relatively low, acts much like a flat voucher, and obtains a level of welfare close to the optimal voucher. Across a range of counterfactuals, we find that more efficient subsidy mechanisms share three features: they retain the marginal elasticity of demand, limit the exercise of market power, and preserve the link between prices and marginal costs.

We use linked survey and administrative data to document differences across multiple socio-economic and demographic groups in the extent of adverse economic and health impacts of the first two years of the COVID-19 pandemic in the United States. Across a wide set of characteristics-including race/ethnicity, education, industry, and occupation-the impacts of the pandemic on all-cause mortality and on employment were disproportionately concentrated in the same groups in the population. As the pandemic progressed, disparities in the pandemic's mortality impacts narrowed substantially between Black and White Americans and between Hispanic and White Americans, but persisted along the educational divide. For economic damages, only Hispanic-White disparities narrowed; Black-White and educational disparities persisted for the first two years of the pandemic. We also document greater mortality impacts for lower income individuals, with this negative income-excess mortality gradient becoming steeper in the pandemic's second year. Together our findings-using a consistent set of methods and measures on nationally representative data with a wide set of measures of socio-economic status-paint a detailed picture of the heterogeneous impacts of the first two years of the COVID-19 pandemic on health and economic well-being.

Is government guiding the invisible hand at the top of the labor market? We use new administrative data to measure physicians’ earnings and estimate the influence of health care policies on these earnings, physicians’ labor supply, and the allocation of talent. Combining the administrative registry of U.S. physicians with tax data, Medicare billing records, and survey responses, we find that physicians’ annual earnings average $350,000 and make up 8.6% of national health care spending. Business income makes up one-quarter of earnings and is systematically underreported in survey data. Earnings increase steeply early in the career, and there are major differences across specialties, regions, and firm sizes. The geographic pattern of earnings is unusual compared with other workers. We argue that these patterns reflect policy choices to subsidize demand for physician care, amplified by restrictions on physician entry, especially in certain specialties. Health policy has a major impact on the margin: 25% of physician fee revenue driven by Medicare reimbursements accrues to physicians personally. Physicians earn 8% of public money spent on insurance expansion. These policies in turn affect the type and quantity of medical care physicians supply, retirement timing, and the allocation of talent across specialties.

We analyze data from a survey we administered during the COVID-19 pandemic to investigate the relationship between people’s subjective beliefs about risks and their private protective behaviors. On average, people substantially overestimate the absolute level of risk associated with economic activity, but have directionally correct signals about their relative risk based on their demographic characteristics. Subjective risk beliefs are predictive of changes in economic activities independent of government policies. Government mandates restricting economic behavior, in turn, attenuate the relationship between subjective risk beliefs and protective behaviors.