Uterus at a Price: Disability Insurance and Hysterectomy

Taiwanese Labor, Government Employee, and Farmer Insurance programs provide 5-6 months of salary to enrollees who undergo hysterectomy or oophorectomy before their 45th birthday. These programs result in more and earlier treatments, referred as, respectively, inducement and timing effects. Difference-in-difference and nonparametric methods are used to estimate these effects on surgery hazards between 1997 and 2011. For Government Employee and Labor Insurance, inducement is 11-12% of all hysterectomies, and timing 20% of inducement. For oophorectomy, both effects are insignificant. Induced hysterectomies increase benefit payments and surgical costs, at about the cost of a mammogram and 5 pap smears per enrollee.