Nicolas Robert Ziebarth

• PhD
• Professor at ZEW Mannheim and University of Mannheim and Cornell University

Childhood obesity is one of the most serious public health challenges of the twenty-first century. While small-scale experiments change behaviors among adults in the short run, we know little about the effectiveness of large-scale policies or the longer-run impacts. To nudge primary school children into a long-term habit of exercising, the German s...

This chapter summarizes and discusses developments and policy changes in the public disability benefit systems of five countries of the Organisation for Economic Cooperation and Development (OECD)—the Netherlands, Sweden, Great Britain, Germany, and Australia—over the past five decades. All five countries experienced substantial increases in their...

The Affordable Care Act requires insurers to offer cost‐sharing reductions (CSRs) to low‐income consumers on the marketplaces. We link 2013–2015 All‐Payer Claims Data to 2004–2013 administrative hospital discharge data from Utah and exploit policy‐driven differences in the actuarial value of CSR plans that are solely determined by income. This allo...

How do patient and provider incentives affect the provision of long-term care? Our analysis of 551 thousand nursing home stays yields three main insights. First, Medicaid-covered residents prolong their stays instead of transitioning to community-based care due to limited cost-sharing. Second, when facility capacity binds, nursing homes shorten Med...

Health expenditure data almost always include extreme values, implying that the underlying distribution has heavy tails. This may result in infinite variances as well as higher-order moments and bias the commonly used least squares methods. To accommodate extreme values, we propose an estimation method that recovers the right tail of health expendi...

Using the National Compensation Survey from 2009 to 2022 and difference-in-differences methods, we find that state-level sick pay mandates are effective in broadening access for U.S. workers. Increases in coverage reach 30ppt from a 63% baseline five years post-mandate. Mandates have more bite in jobs with low pre-mandate coverage. Further, mandate...

We study how public school teachers use paid leave. Most U.S. sick leave schemes operate as individualized credit accounts—paid leave is earned and unused leave accumulates, producing an employee-specific leave balance. We construct an administrative data set containing the daily balances and leave behavior of 982 teachers from 2010-2018. We find t...

Objective Evidence shows that booster shots offer strong protection against the Omicron variant of COVID-19. However, we know little about why individuals would receive a booster compared to the initial decision to vaccinate. We investigate and assess the factors that affect individuals' reported willingness to receive the COVID-19 vaccine booster....

Background To respond to the U.S. opioid crisis, new models of healthcare delivery for opioid use disorder treatment are essential. We used a qualitative approach to describe the implementation of a low-threshold buprenorphine treatment program in an independent, community-based medical practice in Ithaca, NY. Methods We conducted 17 semi-structur...

The health risks of the current COVID-19 pandemic, together with the drastic mitigation measures taken in many affected nations, pose an obvious threat to public mental health. To assess predictors of poor mental health in the context of the COVID-19 pandemic, this study first implements survey-based measures of health perception biases among Chine...

The COVID-19 pandemic has disrupted most aspects of our lives: how we work, how we socialize, how we provide health care, and how we take care of our most vulnerable members of society. In this perspectives article, we provide a multidisciplinary overview of existing research covering these fields. Moreover, we enrich this research overview with ne...

Background: Based on recent experiences with the COVID-19 pandemic, designers and design researchers are crafting guidelines for the development of future environments. In this context, this paper focuses on future best practices regarding environments for health, hospitality and senior care. Methods: An extensive literature review was conducted, t...

Using a randomized field experiment, we show that health care specialists cream-skim patients by their expected profitability. In the German two-tier system, outpatient reimbursement rates for both public and private insurance are centrally determined but are significantly higher for the privately insured. In our field experiment, following a stand...

We study US sick leave use and unaddressed sick leave needs in the midst of the global severe acute respiratory syndrome coronavirus type 2 (SARS COV 2) pandemic based on a representative survey. More than half of all US employees are unaware of the new emergency sick leave options provided by the federal Families First Coronavirus Response Act (FF...

Background Stigma is a barrier to the uptake of buprenorphine to treat opioid use disorder. Harm reduction treatment models intend to minimize this stigma by organizing care around non-judgmental interactions with people who use drugs. There are few examples of implementing buprenorphine treatment using a harm reduction approach in a primary care s...

This paper investigates the role of biased health perceptions as a potential driving force of risky health behaviors. We define absolute and relative health perception biases, illustrate their measurement in surveys and provide evidence on their relevance. Next, we decompose the theoretical effect into its extensive and intensive margin: When the e...

https://www.aei.org/research-products/report/paid-leave-for-illness-medical-needs-and-disabilities-issues-and-answers/

This analysis examines whether the coronavirus disease 2019 (COVID-19) emergency sick leave provision of the bipartisan Families First Coronavirus Response Act (FFCRA) reduced the spread of the virus. Using a difference-in-differences strategy, we compared changes in newly reported COVID-19 cases in states where workers gained the right to take pai...

A growing economic literature studies the optimal design of social insurance systems and the empirical identification of welfare-relevant externalities. In this paper, we test whether mandating employee access to paid sick leave has reduced influenza-like-illness (ILI) transmission rates as well as pneumonia and influenza (P&I) mortality rates in t...

To insure policyholders against contemporaneous health expenditure shocks and future reclassification risk, long-term health insurance constitutes an alternative to community-rated short-term contracts with an individual mandate. Relying on unique claims panel data from a large private insurer in Germany, we study a real-world long-term health insu...

A growing economic literature studies the optimal design of social insurance systems and the empirical identification of welfare-relevant externalities. In this paper, we test whether mandating employee access to paid sick leave has reduced influenza-like-illness (ILI) rates in the United States. Using uniquely compiled data from administrative sou...

This paper exploits temporal and spatial variation in the implementation of nine-city- and four state-level U.S. sick pay mandates to assess their labor market consequences. We use the synthetic control group method and traditional difference-in-differences models along with the Quarterly Census of Employment and Wages to estimate the causal effect...

Chronic sleep deprivation is a significant and understudied public health issue. Using BRFSS survey data from the United States and an administrative census of 160 million hospital admissions from Germany, we study the causal relationship between sleep and health. Our empirical approach exploits the end of Daylight Saving Time in a quasi-experiment...

In a randomized field experiment, we show that health care specialists cream-skim patients by their expected profitability. In the German two-tier system, outpatient reimbursement rates for both public and private insurance are centrally determined but are more than twice as high for the privately insured. In our study, the same hypothetical patien...

Hosting the Olympic Games costs billions of taxpayer dollars. Following a quasi-experimental setting, this paper assesses the intangible impact of the London 2012 Olympics, using a novel panel of 26,000 residents in London, Paris, and Berlin during the summers of 2011, 2012, and 2013. We show that hosting the Olympics increases subjective well-bein...

This paper links representative enrollee panel data to health plan data on (i) prices, (ii) service quality , and (iii) non-essential benefits for the German statutory multi-payer market and the years 2007 to 2010. We first show that, although heavy federal regulation ensures a simple choice architecture, the majority of health plans are dominated-...

This paper provides an analytical framework and uses data from the U.S. and Germany to test for the existence of contagious presenteeism and negative externalities in sick leave insurance. The first part exploits high-frequency Google Flu data and the staggered implementation of U.S. sick pay mandates to show, using a reduced-form framework, that p...

This paper exploits temporal and spatial variation in the implementation of nine city- and four state-level U.S. sick pay mandates to assess their labor market consequences. We use the Synthetic Control Group Method and traditional Difference-in-Differences models along with the Quarterly Census of Employment and Wages to estimate the causal effect...

The theory of compensating wage differentials (CWDs) assumes that firms supply and workers demand workplace safety, predicting a positive relationship between accident risk and wages. This paper allows for safety provision by workers, which predicts a countervailing negative relationship between individual risk and wages: firms pay higher wages for...

This paper empirically investigates biased beliefs about the risks of smoking. First, it confirms the established tendency of people to over estimate the lifetime risk of a smoker to contract lung cancer. In this paper’s survey, almost half of all respondents overestimate this risk. However, 80% under estimate lung cancer deadliness. In reality, le...

This paper studies the short‐term impact of public smoking bans on hospitalizations in Germany. It exploits the staggered implementation of smoking bans over time and across the 16 federal states along with the universe of hospitalizations from 2000 to 2008 and daily county‐level weather and pollution data. Smoking bans in bars and restaurants have...

This study assesses the short and medium-term impact of extreme temperatures on population health and health-related costs in Germany. For 1999 to 2008, we link the universe of 170 million hospital admissions and all 8 million deaths with weather and pollution data at the day-county level. Extreme heat significantly and immediately increases hospit...

This chapter reviews the existing empirical evidence on how social insurance affects health. Social insurance encompasses programs primarily designed to insure against health risks, such as health insurance, sick leave insurance, accident insurance, long-term care insurance, and disability insurance as well as other programs, such as unemployment i...

In the past decade, dozens of US cities and seven US states have mandated employers to offer paid sick leave. This column investigates the relationship between sick pay and influenza-like illness rates. The results suggest that the mandates reduced the spread of infectious diseases, while having no significant effect on employment or wages.

This paper provides new evidence on biased perceptions about the risks of smoking. It studies predictors of lung cancer risk perceptions. Lung cancer is one of the deadliest and most aggressive cancer types with 5-year survival rates of only up to 15%. A cross-sectional online survey in Berlin assessed lung cancer risk perceptions among smokers (n...

We study theoretically and empirically how consumers in an individual private long-term health insurance market with front-loaded contracts respond to a newly mandated portability requirement of their old-age provisions. To foster competition, effective 2009, the German legislature made the portability of standardized old-age provisions mandatory....

To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders....

To host the Olympic Games, governments are willing to spend billions of taxpayer dollars. This paper focuses on the 2012 Olympic Summer Games and estimates their intangible benefits on Londoners, versus Parisians and Berliners, in a quasi natural experiment setting. We show that hosting the Olympics increases subjective well-being of the host city'...

We study theoretically and empirically how consumers in an individual private long-term health insurance market with front-loaded contracts respond to a newly mandated portability requirement of their old-age provisions. To foster competition, effective 2009, the German legislature made the portability of standardized old-age provisions mandatory....

This paper assesses the effectiveness of child safety seat laws in the US. Over the past 35 years, 181 of these laws have steadily increased mandatory child safety seat restraint ages. We exploit state-year level variation in these 181 laws and estimate Difference-in Differences and well as triple difference models using FARS data from 1978 to 2011...

Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009-11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan, the United States, and the Canadian province of Q...

This paper provides an analytical framework and uses data from the U.S. and Germany to test for the existence of contagious presenteeism and negative externalities in sick leave insurance. The first part exploits high-frequency Google Flu data and the staggered implementation of U.S. sick pay mandates to show in a reduced-form framework that popula...

We study theoretically and empirically how consumers in an individual private long‐term health insurance market with front‐loaded contracts respond to a newly mandated portability requirement of their old‐age provisions. To foster competition, effective 2009, the German legislature made the portability of standardized old‐age provisions mandatory....

To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders....

We exploit cigarette tax variation across US states from 2001 to 2012 to show how taxing inelastic consumption goods can induce low-income households to enroll in public assistance programs. Using a novel household panel of monthly food stamp enrollment from the Current Population Survey, we enrich standard cigarette tax difference-in-differences m...

This paper develops a dynamic model to illustrate how diet and body weight change when novel food products become available to consumers. We propose a microfounded test to empirically discriminate between habit and taste formation in intertemporal preferences. Moreover, we show that 'novelty consumption' and endogenous preferences can explain the p...

This paper provides field evidence on how price framing affects consumers’ decision to switch health plans. In 2009 German federal regulation required insurers to express premium differences between standardized health plans in absolute euro values relative to a federal reference price, rather than in percentage point payroll tax differences. Repre...

Commentary published in the Star Tribune on April 19, 2016

Although industrialized nations have long provided public protection to working-age individuals with disabilities, the form has changed over time. The impetus for change has been multi-faceted: rapid growth in program costs; greater awareness that people with impairments are able and willing to work; and increased recognition that protecting the ec...

We use claims panel data from a big German private health insurer to provide detailed individual-level evidence on medical spending between 2005 and 2011. This includes evidence on the distribution of medical spending, the dependence of medical spending on age and other demographic characteristics, its persistence, and how medical spending evolves...

We show that hosting the Olympic Games in 2012 had a positive impact on the life satisfaction and happiness of Londoners during the Games, compared to residents of Paris and Berlin. Notwithstanding issues of causal inference, the magnitude of the effects is equivalent to moving from the bottom to the fourth income decile. But they do not last very...

We show that hosting the Olympic Games in 2012 had a positive impact on the life satisfaction and happiness of Londoners during the Games, compared to residents of Paris and Berlin. Notwithstanding issues of causal inference, the magnitude of the effects is equivalent to moving from the bottom to the fourth income decile. But they do not last very...

We show that hosting the Olympic Games in 2012 had a positive impact on the life satisfaction and happiness of Londoners during the Games, compared to residents of Paris and Berlin. Notwithstanding issues of causal inference, the magnitude of the effects is equivalent to moving from the bottom to the fourth income decile. But they do not last very...

We show that hosting the Olympic Games in 2012 had a positive impact on the life satisfaction and happiness of Londoners during the Games, compared to residents of Paris and Berlin. Notwithstanding issues of causal inference, the magnitude of the effects is equivalent to moving from the bottom to the fourth income decile. But they do not last very...

We show that hosting the Olympic Games in 2012 had a positive impact on the life satisfaction and happiness of Londoners during the Games, compared to residents of Paris and Berlin. Notwithstanding issues of causal inference, the magnitude of the effects is equivalent to moving from the bottom to the fourth income decile. But they do not last very...

To design effective and commonly accepted public health policies against performance-enhancing drugs (PED), it is important to understand general population attitudes. This article elicits PED attitudes in the Berlin population and compares response rates of former athletes (N= 496) with those of non-athletes (N= 1686). In addition, exploiting the...

Objective: To profile the sick leave landscape in the United States. Data sources: The 2011 Leave Supplement of the American Time Use Survey. Study design: Bivariate and multivariate analyses to identify (i) employees without sick pay coverage and (ii) employees who attend work sick. Principal findings: Sixty-five percent of full-time employ...

We study the impact of the Fukushima disaster on environmental concerns, well-being, risk aversion, and political preferences in Germany, Switzerland, and the UK. In these countries, overall life satisfaction did not significantly decrease, but the disaster significantly increased environmental concerns among Germans. One underlying mechanism likel...

We study the impact of the Fukushima disaster on environmental concerns, well-being, risk aversion, and political preferences in Germany, Switzerland, and the UK. In these countries, overall life satisfaction did not significantly decrease, but the disaster significantly increased environmental concerns among Germans. One underlying mechanism likel...

This study comprehensively assesses the immediate effects of extreme weather conditions and high ambient air pollution on population health. For Germany and the years 1999 to 2008, we link the universe of all 170 million hospital admissions and all 8 million deaths with weather and pollution data reported at the day-county level. Extreme heat signi...