Socioeconomic Inequality in Life Expectancy: Perception and Policy Demand in the United States and Germany
Lasse J. Jessen, Patrick Nüß, Jens Ruhose
IWH Discussion Papers,
No. 12,
2026
Abstract
Using survey experiments in the United States and Germany with about 12,000 participants, we study perceptions of socioeconomic inequality in life expectancy and policy demand. Respondents overestimate the rich-poor gap in both countries, judging the life expectancy of the rich roughly accurately but placing that of the poor well below its true level. These misperceptions vary little with political orientation or other characteristics. Correcting them shifts concern but leaves policy demand largely unchanged across general, specific, and real-stakes measures. Instead, demand divides politically, sharply in the United States and much less in Germany, consistent with views about the role of government rather than the inequality itself shaping policy demand.
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Time To Close the Socioeconomic Gap in Access to Childcare
Henning Hermes, Philipp Lergetporer, Frauke Peter, Simon Wiederhold
Nature Human Behaviour,
Vol. 10 (7),
2026
Abstract
Socioeconomic inequalities shape who accesses early childcare, even in countries that claim universal provision. This entrenched inequality limits child development, women’s employment and gender equality — but governments have clear tools to close the gap.
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Can Nonprofits Save Lives Under Financial Stress? Evidence from the Hospital Industry
Janet Gao, Merih Sevilir
SSRN Working Paper,
No. 4946064,
2025
Abstract
We compare the effects of external financing shocks on patient mortality at nonprofit and for-profit hospitals. Using confidential patient-level data, we find that patient mortality increases to a lesser extent at nonprofit hospitals than at for-profit ones facing exogenous, negative shocks to debt capacity. Such an effect is not driven by patient characteristics or their choices of hospitals. It is concentrated among patients without private insurance and patients with higher-risk diagnoses. Potential economic mechanisms include nonprofit hospitals' having deeper cash reserves and greater ability to maintain spending on medical staff and equipment, even at the expense of lower profitability. Overall, our evidence suggests that nonprofit organizations can better serve social interests during financially challenging times.
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14.05.2025 • 16/2025
Private ownership boosts hospital performance
New research by the Halle Institute for Economic Research (IWH) and ESMT Berlin shows that private equity (PE) acquisitions lead to substantial operational efficiency gains in hospitals, challenging common public concerns. The study reveals that hospitals acquired by PE firms significantly reduce costs and administrative staff without increasing closure rates or harming patient care.
Merih Sevilir
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Entwicklung der öffentlichen Gesundheitsausgaben
Götz Zeddies
Wirtschaftsdienst,
Vol. 103 (6),
2023
Abstract
Die sozialen Sicherungssysteme in Deutschland basieren auf dem Umlageverfahren, bei dem die Ausgaben der Sozialversicherungen in der laufenden Periode durch Einnahmen aus Beiträgen, die auf die Einkommen der abhängig Beschäftigten erhoben werden, gedeckt werden. Vor dem Hintergrund des demografischen Wandels, der in den kommenden Jahren immer stärker zum Tragen kommen wird, wird häufig die Nachhaltigkeit der umlagefinanzierten sozialen Sicherungssysteme hinterfragt, weil sich das Verhältnis von Beitragszahlern und Leistungsempfängern ändern wird. Dies dürfte sich zwar vor allem bei der gesetzlichen Rentenversicherung auswirken, aber auch bei der gesetzlichen Kranken- und der Pflegeversicherung.
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Inequality in Life and Death
Martin S. Eichenbaum, Sergio Rebelo, Mathias Trabandt
IMF Economic Review,
Vol. 70 (March),
2022
Abstract
We argue that the COVID epidemic disproportionately affected the economic well-being and health of poor people. To disentangle the forces that generated this outcome, we construct a model that is consistent with the heterogeneous impact of the COVID recession on low- and high-income people. According to our model, two-thirds of the inequality in COVID deaths reflect preexisting inequality in comorbidity rates and access to quality health care. The remaining third stems from the fact that low-income people work in occupations where the risk of infection is high. Our model also implies that the rise in income inequality generated by the COVID epidemic reflects the nature of the goods that low-income people produce. Finally, we assess the health-income trade-offs associated with fiscal transfers to the poor and mandatory containment policies.
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Inequality in Life and Death
Martin S. Eichenbaum, Sergio Rebelo, Mathias Trabandt
Abstract
We argue that the Covid epidemic disproportionately affected the economic well-being and health of poor people. To disentangle the forces that generated this outcome, we construct a model that is consistent with the heterogeneous impact of the Covid recession on low- and high-income people. According to our model, two thirds of the inequality in Covid deaths reflect pre-existing inequality in comorbidity rates and access to quality health care. The remaining third, stems from the fact that low-income people work in occupations where the risk of infection is high. Our model also implies that the rise in income inequality generated by the Covid epidemic reflects the nature of the goods that low-income people produce. Finally, we assess the health-income trade-offs associated with fiscal transfers to the poor and mandatory containment policies.
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Kommentar: Wir brauchen eine neue Corona-Strategie
Reint E. Gropp
Wirtschaft im Wandel,
No. 1,
2021
Abstract
Die gegenwärtige Corona-Strategie der Bundesregierung, wenn man sie denn so nennen kann, konzentriert sich darauf, besonders gefährdete Personen durch Impfung zu schützen und die Ansteckung aller anderen durch den Lockdown zu vermeiden. Sie ignoriert, dass Menschen im täglichen Leben immer Risiken eingehen und dabei auch Risiken berücksichtigen, die durch das Verhalten anderer entstehen. Sie entscheiden selbst, wie stark sie sich gefährden, je nach ihrer persönlichen gesundheitlichen Situation und Risikoaffinität. Die Möglichkeit, Risiken einzugehen, ist ein inhärenter Teil einer freiheitlichen Gesellschaft: Die Gesellschaft vertraut prinzipiell dem Einzelnen, einigermaßen vernünftige Entscheidungen zu treffen – und die Konsequenzen zu tragen, wenn die Dinge schiefgehen. Der Staat setzt dabei die Rahmenbedingungen, aber niemals mit dem Ziel, das Risiko für den Einzelnen auf null zu drücken.
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Kommentar: Das Corona-Dilemma
Reint E. Gropp
Wirtschaft im Wandel,
No. 1,
2020
Abstract
Die Politik steht zurzeit vor einem scheinbar unlösbaren Dilemma. Einerseits sollen die Infektionszahlen niedrig gehalten werden: um die medizinische Infrastruktur nicht zu überfordern, und weil in Abwesenheit einer wirkungsvollen Behandlung Menschenleben gerettet werden sollen. Andererseits wäre aber die Ansteckung großer Teile der Bevölkerung (jünger als 60 Jahre und ohne Vorerkrankungen) vielleicht sogar erstrebenswert, weil die Symptome bei dieser Gruppe ohnehin kaum bis gar nicht wahrnehmbar sind und durch sie eine Herdenimmunität entstehen würde, die systematisch Infektionsketten unterbrechen könnte.
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Integrated Assessment of Epidemic and Economic Dynamics
Oliver Holtemöller
IWH Discussion Papers,
No. 4,
2020
Abstract
In this paper, a simple integrated model for the joint assessment of epidemic and economic dynamics is developed. The model can be used to discuss mitigation policies like shutdown and testing. Since epidemics cause output losses due to a reduced labor force, temporarily reducing economic activity in order to prevent future losses can be welfare enhancing. Mitigation policies help to keep the number of people requiring intensive medical care below the capacity of the health system. The optimal policy is a mixture of temporary partial shutdown and intensive testing and isolation of infectious persons for an extended period of time.
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