Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/185088 
Year of Publication: 
2018
Series/Report no.: 
IZA Discussion Papers No. 11628
Publisher: 
Institute of Labor Economics (IZA), Bonn
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 flexible difference-in-differences 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. We present evidence suggesting that the decline is associated with access to health services but not sick pay. This finding may be explained by insurance fund physicians transmitting new knowledge on infectious disease prevention.
Subjects: 
health insurance
mortality
demographic transition
Prussia
JEL: 
I13
I18
N33
J11
Document Type: 
Working Paper

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