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Title: Bismarck's Health Insurance and the Mortality Decline

Author(s): Stefan Bauernschuster, Anastasia Driva and Erik Hornung

Publication Date: August 2017

Keyword(s): demographic transition, Health Insurance, Mortality and Prussian Economic History

Programme Area(s): Economic History and Public Economics

Abstract: We investigate the impact on mortality of the world's first compulsory health insurance, established by Otto von Bismarck, Chancellor of the German Empire, in 1884. Employing a multi-layered empirical setup, we draw on international comparisons and difference-in-differences strategies using Prussian administrative panel data to exploit differences in eligibility for insurance across occupations. All approaches yield a consistent pattern suggesting that Bismarck's Health Insurance generated a significant mortality reduction. The results are largely driven by a decline of deaths from infectious diseases. We present prima facie evidence that diffusion of new hygiene knowledge through physicians was an important channel.

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Bibliographic Reference

Bauernschuster, S, Driva, A and Hornung, E. 2017. 'Bismarck's Health Insurance and the Mortality Decline'. London, Centre for Economic Policy Research. https://cepr.org/active/publications/discussion_papers/dp.php?dpno=12200