Carole Roan Gresenz: Economist on the Run
Carole Roan Gresenz, Ph.D., is a senior economist at RAND Corporation in
We talked to Carole about crowd out, discovering
Why did you choose
We are interested in these three states because they have all experimented with universal coverage for children. In the absence of major health care reform at the federal level, states have been important laboratories for thinking and working with incremental health care reforms. In particular, we know that uninsured children are at risk for not having appropriate preventive care and that a healthy childhood lays the foundation for health in the future. Because of this, insuring kids gets widespread support.
How does that square with the fact that SCHIP reauthorization has failed to pass?
Much of that debate centers on higher income children who have private health insurance coverage, but become newly eligible for public health insurance under the expansion of SCHIP. If we offer government-sponsored insurance are we crowding out private insurance from the market? Right now, we do not know because we’ve never tried to give this kind of health insurance eligibility to higher income children.
What methods are you using in your research to address these questions?
The key to success for this project is integrating quantitative and qualitative methods. On the quantitative side, we are tracking how health insurance outcomes change over time as these programs are implemented. We will use data from the Current Population Survey and data from state-conducted surveys. We will also meet with policy-makers and other stakeholders to understand the political context in which these reforms were passed and to identify threats to sustainability. Implementation varies considerably by state, so we want to identify salient differences and analyze how they affect the success of the program.
As an economist, are you more inclined to the quantitative approach?
I do a little bit of both. As an economist I am definitely more comfortable on the quantitative side, but over the past few years I’ve been more involved with qualitative research. Numbers and figures are really important, but there are issues that don’t emerge from the quantitative data. To get the whole picture, you have to talk to community residents, providers, and others.
I got my Ph.D. in economics from Brown, where I trained as a labor economist. When I came to RAND in 1996, there were a lot of opportunities in health research, and I dove in. I started with mental health care issues. I liked the process of learning about the institutions of health. I think of economics as a toolkit that you can use for a variety of issues – for instance, I have also done work looking at housing choices among U.S. military service members. I like to keep a broad research agenda and work on a lot of different topics.
Did you enjoy
I did not like the weather in
If you weren’t a health services researcher at
When I was little I dreamt of being a gymnast. We had a sixth grade gymnastics team called the “Olympians” and I was on it—but that is about as far as I got. I did a lot of somersaults in my front yard. Right now if I weren’t working, I would certainly spend more time running. Each year I try to do a half marathon and a 10-mile race. RAND generously has a locker room right at the office, so I’m able to run every day. I have to run every day or I can’t think. The other day, someone stopped me and asked whether I had an athletic scholarship here at