Amelie Wuppermann

This study investigates whether the regional elections held in the German state of Bavaria on March 15 of 2020 — shortly after the WHO declared COVID-19 a global pandemic — contributed to the spread of COVID-19 cases and COVID-related deaths. Constructing synthetic controls for each of Bavaria’s 96 districts based on non-Bavarian German districts, we find that over a third of the increase in positive test results cannot be explained by district-level demographic, economic, health or child care characteristics, nor by the distance to Ischgl — a proxy for skiing tourism associated with the first COVID-19 wave in Germany. Within Bavaria, districts with higher voter participation witnessed a steeper increase in COVID-19 cases and deaths after the election, while controlling for alternative drivers, such as the distance to Ischgl and the number of strong-beer festivals. Our results are highly robust and suggest that an unfortunate timing of elections contributed to the spreading of an infectious disease.

Risk adjustment schemes are meant to compensate health plans adequately for their enrollees’ expected health care costs so as to prevent incentives for risk selection in competitive health insurance systems with restrictions on risk-rating of premiums. However, important under-/overcompensation for specific groups of enrollees persists in many of the current risk adjustment schemes in place. While for some groups, a direct inclusion of the group in the risk adjustment scheme can solve this issue, others cannot be included in the scheme, e.g. because the status is not observed for every enrollee. Van Kleef et al. (Eur. J. Health Econ. 18, 1137–1156 (2017)) suggest constrained regression as a remedy. In this paper, we explore constrained regression in the context of the German morbidity-based risk adjustment scheme. We find that constrained regression is technically feasible in the German context and has the potential to improve upon the current base model in terms of overall under-/overcompensation and even individual model fit, particularly if the constraint is not set to fully eliminate under-/overcompensation in the respective group but to only partial elimination. Before implementation of constrained regression, a policy-discussion on which groups should be included in constructing an overall measure of under-/overcompensation is needed.

In the United States, individuals with disabilities and those aged ≥65 can supplement their Medicare with so-called stand-alone Medicare Part D prescription drug plans. Beneficiaries can switch their stand-alone prescription drug plans annually, but most do not. Indirect evidence has raised concerns that non-switchers do not even make plan comparisons (labeled “inattention”), but direct evidence is scarce. Therefore, we surveyed 439 beneficiaries of Medicare Part D plans from a nationally representative adult sample after the 2024 open-enrollment period. Overall, 53% self-reported making no comparisons. Of those who did not compare, 98% did not switch (vs 67% of those who did compare). Multinomial regressions revealed that beneficiaries who neither compared nor switched were more likely than switchers to report difficulties with comparing and switching, experiencing no plan-related discontinuation, changes, or dissatisfaction, not using advisors or the plan-finder website, and receiving potentially confusing mailings. Non-switchers who did compare were similar to switchers in reporting few difficulties and relying on advisors and the plan-finder website, but they were less likely than switchers to report plan-related changes, discontinuation, or dissatisfaction, while being more likely to report receiving mailings and having no college degree. We discuss insights for policy-making.

Sustainable nutrition is becoming increasingly relevant in society. This empirical study suggests that green nudges can encourage consumers to buy food that has an ecology or animal welfare label.This paper analyzes whether green nudges ‐ displaying nature pictures or providing information on other people’s behavior before the consumer makes a choice ‐ can promote more environmentally friendly food choices. Based on data from an online, discrete choice experiment conducted in Germany, in which randomly selected groups of participants were shown either one of the nudges (treatment groups) or no nudge (control group), the study finds that green nudges increase individuals’ willingness to pay more for products that have ecology and animal welfare labels. However, consumers in one of the treatment groups were willing to pay more for meat rather than the meat alternative, indicating that nudges can have an effect opposite from that intended. Future research should investigate the impact of these relatively cheap interventions with a representative sample and in a field setting.