The choice of detecting Down syndrome: does money matter?

The prenatal diagnosis of Down syndrome (amniocentesis) presents parents with a complex dilemma which requires comparing the risk of giving birth to an affected child and the risk of losing an unaffected child through amniocentesis-related miscarriage. Building on the specific features of the French Health insurance system, this paper shows that variation in the monetary costs of the diagnosis procedure may have a very significant impact on how parents solve this ethical dilemma. The French institutions make it possible to compare otherwise similar women facing very different reimbursement schemes and we find that eligibility to full reimbursement has a largely positive effect on the probability of taking an amniocentesis test. By contrast, the sole fact of being labelled 'high-risk' by the Health system seems to have, as such, only a modest effect on subsequent choices. Finally, building on available information on post-amniocentesis outcomes, we report new evidence suggesting that amniocentesis increases the risk of premature birth and low weight at birth.

The effect of family size on incentive effects of welfare transfers in two-parent families: an evaluation using experimental data.

Family size is an important determinant of family well-being, and it is a good predictor of poverty. This study examines effects of waiving the 100-hour rule, by family size, and distinguishes between the "work-incentive effects" and the "eligibility effects" of the waiver. The 100-hour rule limits eligibility to aid to two-parent families in which the principal earner is unemployed or underemployed (works fewer than 100 hours per month). The study uses data from the Link-Up randomized experiment, conducted in California's Central Valley, from 1992 to 1994. The findings show that the eligibility effect of the waiver does not differ by family size, but the work-incentive effect does.