Dissertations, Theses, and Capstone Projects

Date of Degree

9-2015

Document Type

Dissertation

Degree Name

Ph.D.

Program

Economics

Advisor

Michael Grossman

Committee Members

Michael Grossman

David Jaeger

Theodore Joyce

Subject Categories

Economics

Keywords

Intrinsic motivation; Merit pay; Teacher bonus

Abstract

In this work, I study several aspects of the economics of education and health. The first chapter focuses on education, analyzing the New York City Teacher Bonus Program. Recent reviews of the program have found lower student test scores at schools randomly chosen to receive performance pay than at control schools not eligible for bonuses. Several studies have suggested lower intrinsic motivation among teachers at treatment schools as a possible mechanism driving these surprising results. The program was abruptly ended after three years, allowing me to use post-trial data to study the program's persistent effect on intrinsic motivation absent any effect on extrinsic motivation. While I replicate prior results showing that the teacher bonus program had a negative impact on student test scores, a difference-in-difference analysis of teacher survey responses indicates that this was not likely caused by a change in teachers' intrinsic motivation. Moreover, a regression discontinuity (RD) study demonstrates that the observed "negative" effect on test scores was not driven by a decline in performance at treatment schools, but rather by an increase in performance at control schools. This finding highlights a risk with RCT experiments in the social sciences: even with proper randomization, the control group may not be a valid counterfactual for the treatment group.

The second chapter -- written with coauthors Jason Hockenberry, Michael Grossman, and Shin-Yi Chou -- focuses on health. We analyze patients' behavioral response to more invasive surgery. 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.

The third chapter combines education and health, studying the effect of schools on students' weight. In this chapter, I use New York City's high school admissions process as a natural experiment to assess the impact of going to a particular school on student weight, BMI, and probability of being overweight or obese. For each high school that admitted students by an oversubscribed lottery, I compare the weight (or BMI, overweight, or obesity) of students admitted to a particular school with the weight of students who applied, but were not admitted based purely on a random number. Analyzing over 100 lotteries, I find statistically significant school effects on student weight about as often as one would expect by chance. I conclude that within NYC the specific high school a student attends is unlikely to have a substantial effect on his or her weight.

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