This paper investigates how employers shape employee healthcare spending and long-term health in a setting where firms neither provide basic health insurance nor directly finance care. Using administrative data on the universe of full-time worker–firm matches in the Netherlands from 2009 to 2016, I apply an Abowd–Kramarz–Margolis (AKM) decomposition to estimate firm contributions to individual healthcare costs.
- Speaker
- Date
- Thursday 26 Jun 2025, 12:00 - 13:00
- Type
- Seminar
- Room
- Kitchen/Lounge E1
- Building
- E Building
Moving to a firm one standard deviation higher in average healthcare spending raises a male worker’s healthcare costs by 16% (14% for females), with particularly large effects for blue-collar workers. While traditionally unhealthy sectors (such as mining and construction) exhibit higher healthcare costs, over 70% of the between-firm variation arises within narrowly defined industries, pointing to substantial heterogeneity in workplace health environments among similar firms. High-cost firms also pay higher wages, consistent with compensating differentials or rent-sharing.
Crucially, exposure to such firms predicts higher mortality and disability risks in later years, even conditional on initial employer fixed effects and baseline individual health costs. Analysis of specialist care records suggests that firm-driven health differences are largely driven by work-related injuries.
These findings highlight the hidden influence of workplace environments on health trajectories and public healthcare spending, and suggest that firms influence health in ways that go beyond traditional occupational or sectoral risks.
Registration
To participate, please send an email to: ae-secr@ese.eur.nl
