Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/171065 
Year of Publication: 
2017
Series/Report no.: 
CESifo Working Paper No. 6601
Publisher: 
Center for Economic Studies and ifo Institute (CESifo), Munich
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.
Subjects: 
health insurance
mortality
demographic transition
Prussia
JEL: 
I13
I18
N33
J11
Document Type: 
Working Paper
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