| The thesis is composed of three chapters. The unifying feature of these chapters is that they address issues that have attracted much attention and debate in the health economics literature. The first examines a particular physician payment mechanism, capitation, that has been proposed and implemented to control health care costs. The second examines the effect of illness among elderly parents on the labour supply of their adult children. Finally, the third chapter attempts to measure some of the benefits of clean air in a health production framework. A short summary of each chapter follows.;As a result of rising health care costs, many countries including the US have turned to managed care and the use of capitation payments. Capitation payments, a mechanism whereby physicians are pre-paid for the medical services they provide, may be an effective way of reducing the over-consumption of medical care associated with the traditional fee-for-service mechanism. Although capitation payments may reduce excessive consumption of medical services, evidence exists that they may in fact lead to the under-provision of care. Using a game-theoretic approach, an examination of physician behaviour and patient well-being under capitation payment is provided. Several contractual arrangements whereby individuals or third parties have access to monitoring mechanisms (such as malpractice litigation) are examined. Conditions are found under which managed care yields more efficient outcomes than traditional fee-for-service.;An important demographic trend in Canada is the aging of the population. As a result, demand for health care services for the sick and elderly is likely to increase. Although care for the sick and elderly is often provided formally, much of the care is provided informally by friends and family members including children. Increased demands on informal care is a trend that may have important implications for the labour market activity of the younger generation. Although previous studies show a negative relationship between hours worked and caregiving, they do not account for the possible endogeneity of the parental living arrangement to the child's labour supply. Using panel data and controlling for such endogeneity, I find that caregiving and cohabiting with a sick elderly parent appear to have smaller effects on labour supply than past literature suggests crests. Nonetheless, given that cohabiting does adversely effect the labour supply of women and that this form of living arrangement is relatively common, the aggregate costs associated with informal caregiving in an intergenerational living arrangement are considerable.;Central to the discussion of air quality degradation is its effect on health and the costs that it may impose on the health care system and the individuals whose health has been affected. Estimating the monetary benefits associated with improved air quality is problematic, as air (and its quality) are public goods. By employing daily environmental data from Montreal and the Quebec Health Survey, the individual's willingness to pay for reductions in ozone are estimated building on the work of Gerking and Stanley (1986). The results suggest a significant relationship between ozone levels, health status and medical care consumption. The results also suggest that the monetary benefits from reducing ozone levels are greater than previously estimated. |
