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2.5.3 The Value of Plan Choice .................... 96<br />

2.5.4 Discussion <strong>and</strong> Sensitivity Analysis ............... 97<br />

2.6 Conclusion ................................. 98<br />

2.7 Appendix to Chapter 2 .......................... 99<br />

2.7.1 Comparison to Dem<strong>and</strong> Estimates <strong>in</strong> Other Sett<strong>in</strong>gs ..... 99<br />

2.7.2 Alternative Specifications of the Dem<strong>and</strong> Model ........ 100<br />

3 Private Coverage <strong>and</strong> Public Costs: Identify<strong>in</strong>g the Effect of Private<br />

Supplemental Insurance on Medicare Spend<strong>in</strong>g 117<br />

3.1 Introduction ................................ 117<br />

3.2 Background ................................ 122<br />

3.3 Data .................................... 124<br />

3.4 Empirical Model ............................. 125<br />

3.4.1 Estimat<strong>in</strong>g equations ....................... 125<br />

3.4.2 Estimation approach ....................... 127<br />

3.5 Identify<strong>in</strong>g Variation ........................... 128<br />

3.5.1 The Instrument .......................... 128<br />

3.5.2 Potential Concerns ........................ 130<br />

3.6 Results <strong>and</strong> Discussion .......................... 132<br />

3.6.1 Premiums <strong>and</strong> Medigap Choice ................. 132<br />

3.6.2 Causal Impact on Costs ..................... 134<br />

3.6.3 Robustness <strong>and</strong> External Validity ................ 136<br />

3.7 Policy Counterfactuals .......................... 137<br />

3.8 Conclusion ................................. 139<br />

4 Do Expir<strong>in</strong>g Budgets Lead to Wasteful Year-End Spend<strong>in</strong>g? Evi-<br />

dence from Federal Procurement 153<br />

4.1 Introduction ................................ 153<br />

4.2 A Model of Wasteful Year-End Spend<strong>in</strong>g ................ 157<br />

4.2.1 The Basel<strong>in</strong>e Model ........................ 157<br />

4.2.2 Rollover Budget Authority .................... 159<br />

4.2.3 Extend<strong>in</strong>g the Model To Allow For Rollover .......... 160<br />

xi

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