Firms differ in their contribution to otherwise similar workers’ healthcare expenditure. I use linked Dutch employer–employee data and workers moving across firms to separate persistent worker and firm differences in healthcare expenditure.
- Speaker
- Date
- Monday 2 Nov 2026, 11:30 - 12:30
- Type
- Seminar
- Room
- 3.02
- Building
- Langeveld Building
Moving a worker to a firm with a fixed effect one standard deviation higher would raise expected annual expenditure by 17.8%. The top-bottom quintile gap in firm effects is comparable to the expenditure gradients by income and wealth. Over half of the across-firm dispersion is within industry. Supporting a health-risk interpretation, moving to a firm with higher coworker expenditure increases use of pain management medication, and exposure to high-effect firms predicts disability and mortality. These firms pay higher wage premia, but mainly between rather than within industries. Because healthcare is collectively financed, firms generate a fiscal externality: healthcare expenditure they do not fully bear.
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