Marcella Alsan, Harvard Kennedy School

"Interest groups, ideology, and indirect lobbying: The rise of private health insurance in the United States".

Abstract:

This study examines the rise of private health insurance in the United States in the post-World War II era. We investigate the role of the American Medical Association (AMA) which financed a campaign against National Health Insurance that was directed by the country’s first political public relations firm, Whitaker & Baxter’s (WB) Campaigns, Inc. The AMA-WB Campaign had two key components: (1) physician outreach to patients and civic organizations; and (2) mass advertising that tied private insurance to “freedom” and “the American way.” We bring together archival data from several novel sources documenting Campaign intensity. We find a one standard deviation increase in Campaign exposure explains about 20% of the increase in private health insurance enrollment and a similar decline in public opinion support for legislation enacting National Health Insurance. We also find suggestive evidence that the Campaign altered the narrative for how legislators and pollsters described health insurance. These findings suggest the rise of private health insurance in the U.S. was not solely due to war-time wage freezes, collective bargaining, or favorable tax treatment. Rather, it was also enabled by an interest group-financed Campaign that used ideology to influence the behavior and views of ordinary citizens.

Marcella Alsan is a Professor of Public Policy at Harvard Kennedy School, She is an applied microeconomist studying health inequality.

Alsan received a BA from Harvard University, a master’s in public health from Harvard School of Public Health, a MD from Loyola University, and a PhD in Economics from Harvard University. Alsan trained at Brigham and Women’s Hospital Hiatt Global Health Equity Residency Fellowship – then combined the PhD with an Infectious Disease Fellowship at Massachusetts General Hospital. Prior to returning to Harvard she was on faculty at Stanford. 

Some recent papers include “Does Diversity Matter for Health: Experimental Evidence from Oakland” and “Tuskegee and the Health of Black Men” – published in the American Economic Review and The Quarterly Journal of Economics, respectively, and a series of papers on messaging during COVID-19 published in medical and public health outlets. She is currently on the Board of Editors for Science Magazine, Co-Editor of the Journal of Health Economics and Co-Chair of the Health Care Delivery Initiative of Abdul Latif Jameel Poverty Action Lab based out of MIT. She is the co-recipient of the 2019 Arrow Award for Best Paper in Health Economics, the 2021 William G. Manning Memorial Award for the Best Research in Health Econometrics and recipient of a MacArthur Fellowship.

You can read more about Marcella Alsan here

CEBI contact: Ida Lykke Kristiansen