MacArthur Fellows Program

Amy Finkelstein

Health Economist | Class of 2018

Formulating robust empirical methods to illuminate the hidden complexities of health care policy and provide data-driven guidance for future innovations in theory and practice

Title
Health Economist
Affiliation
Department of Economics, Massachusetts Institute of Technology
Location
Cambridge, Massachusetts
Age
44
Area of Focus
Economics

About Amy's Work 

Amy Finkelstein is an economist investigating the ways in which health care policy affects health, health care, and well-being. Using novel empirical designs in tandem with sophisticated econometric techniques and theoretical models, Finkelstein has undertaken large-scale studies to shed light on the unintended consequences—for individuals, companies, and society—of well-intentioned programs that manage and distribute medical and social services, particularly in private health insurance markets, and in public Medicare and Medicaid programs.

In early seminal work, Finkelstein unearthed tensions between classic theory models and real-world functioning of private health insurance markets. She and collaborators created new frameworks to better understand adverse selection in insurance markets (that is, the likelihood of less healthy people purchasing more insurance than healthy individuals) and to measure the costs to society of adverse selection in the form of insurance coverage and pricing. Another strand of ongoing research has focused on Medicare and Medicaid programs. In a 2007 study, she analyzed the impact of the introduction of Medicare in 1965 on the health care sector as a whole, not just on individuals, and revealed the previously under-acknowledged role of Medicare in the growth of health spending more broadly, among other insights. Recognizing the opportunity presented by the state of Oregon’s 2008 use of random lottery drawings to expand Medicaid coverage, Finkelstein created the Oregon Health Insurance Experiment, the first randomized controlled trial (RCT) of how covering the uninsured with Medicaid affects their health, health care use, and economic security.  She and co-authors confirm some expected outcomes—such as the financial and psychological benefits of health insurance—but disprove others, in particular showing that increased access to health insurance does not decrease the use of emergency room services. With this work, Finkelstein demonstrated the feasibility and importance of using RCTs for analysis of health policies and programs. She has gone on to use randomized evaluations to study the impact of alternative payment reforms in Medicare and efforts to increase enrollment in the Supplemental Nutrition Assistance Program (SNAP).

In this extensive and growing body of rigorous research, Finkelstein is challenging conventional assumptions about the economics of health care and providing stakeholders and health care institutions with data-driven guidance for validating program refinements and designing future interventions.

Biography

Amy Finkelstein received an A.B. (1995) from Harvard University, an M.Phil. (1997) from the University of Oxford, and a Ph.D. (2001) from the Massachusetts Institute of Technology. She was a junior fellow in the Harvard Society of Fellows prior to joining the faculty of MIT in 2005, where she is currently the John and Jennie S. MacDonald Professor of Economics and the co-founder and co-scientific director of J-PAL North America. Finkelstein is also the founding editor of the American Economic Review: Insights and co-director of the Public Economics Program at the National Bureau of Economic Research. Her scholarly articles have been published in such journals as the American Economic Review, Econometrica, the Quarterly Journal of Economics, Science, and the New England Journal of Medicine, among others.

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Please credit: John D. & Catherine T. MacArthur Foundation

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