Three Essays in Health Economics

Abstract

This thesis comprises three essays in health economics. Chapter 1, co-authored with Dr. Michel Grignon, examines how minimum wage increases affect access to employer-sponsored prescription drug insurance. Using cross-sectional data linked with provincial minimum wages changes from 2008 to 2019, the study identifies threshold effects: increases of 20–30 cents reduce coverage by about three percent, with the strongest impacts among women, young workers, immigrants, and racial minorities.

Chapter 2 evaluates the impact of the Ontario Health Insurance Plan Plus (OHIP+), introduced in 2018 to provide free prescription drug coverage to residents under 25. Applying event study and Difference-in-differences methods with administrative emergency department data, the analysis finds no overall effect on utilization but reveals significant declines among low-income households. This suggests that improved drug access reduced reliance on emergency departments as a substitute source of medication.

Chapter 3 investigates how a cancer diagnosis influences household spending patterns by linking the Canadian Cancer Registry with household expenditure survey data. The results show an average decline in total spending of about seven percent following a diagnosis, with the largest reductions in food and income tax expenditures. Although budget shares remain broadly stable, heterogeneity analysis reveals meaningful reallocations across families with and without children, single parents, and younger households. In contrast, subsequent diagnoses generate smaller adjustments.