Interviewers: Angela Esi Micah and James Buchanan
The Early Career Researcher Interview Series is a new initiative led by the IHEA Early Career Researcher Special Interest Group (ECR-SIG). The aim of this interview series is to showcase the diversity of people in the ECR subgroup in IHEA. By interviewing a variety of ECRs, we hope to describe the many interesting and emerging career paths available to ECRs in health economics, highlight the choices that individuals have made to help them to reach this point in their career, and reveal how ECRs are navigating the various challenges that they face.
The eighth interview of this series is with Véra Zabrodina. Véra is a PhD student in Applied Economics at the Faculty of Business and Economics at the University of Basel. Her research interest is in understanding the trade-off in risk protection and incentives in social insurance, particularly in the health and labor markets. Angela Esi Micah and James Buchanan, two of the conveners of the ECR-SIG, spoke to Véra in January 2020 to discuss her career to date.
Hi Vera, many thanks for talking to us today. Can you provide an overview of your career before you began your PhD to start our conversation?
I graduated with a Master’s in Economics from the University of Lausanne in 2015. During my program, I wrote my Master’s thesis in health economics, and realized that I wanted to do more research in that field. Upon completion of the program, I was lucky to be offered a position as a research fellow at the Institute for Social and Preventive Medicine at the University of Lausanne. It is a public health research institute, and a very interdisciplinary environment. There, I worked with health economists, physicians and epidemiologists on diverse research projects for both academic and policy purposes. To give you an example, my first project concerned the healthcare consumption of prisoners. We used a unique dataset on the healthcare utilization and diagnoses of prisoners, and wrote descriptive papers aimed at understanding the health needs of this understudied population. Next, I got to work on a policy project for public health authorities in Switzerland, where we looked at the need to regulate the supply of diagnostic imaging equipment, in particular CT and MRI scanners. There is a strong concern that there is too much investment in these technologies, and that it might be efficient to regulate their supply to limit the overuse of costly imaging examinations. As a follow-up to this project, my co-authors and I wrote the paper on supplier-induced demand for diagnostic imaging that I presented at the last iHEA Congress in Basel.
Can you be specific about the timelines for all of these interesting projects?
Each of these projects typically took a few months. In total, I spent two years working with the Institute. Then, in the autumn of 2017, I joined the faculty of Business and Economics at the University of Basel for my doctoral studies.
So that means you are currently in your third year?
Yes, I am in my third year.
Ok, so why did you choose the University of Basel?
When I was working at the Institute for Social and Preventive Medicine, I was exposed to both the policy and academic worlds. I realized that I really liked academia, and that if I wanted to continue in that direction, I had to complete a PhD. As my previous degree was in Economics, I wanted to go back to that environment – a classical Economics department. In addition to health I wanted to work in labor economics, so I applied to the structured program in Basel and had a very nice interview with my supervisor there. For a PhD supervisor, I was looking for someone who was very strong in applied econometrics and who would also give me a lot of flexibility and initiative in developing projects. Basel seemed like a very attractive environment, as there is a strong focus on applied and policy-relevant research. I also liked that it is not a huge, but very diverse faculty.
Also, the structured program format means that you have a year of coursework before doing your research. I completed the program for beginning doctoral students in Economics at the Study Center Gerzensee. This is a program with fundamental courses in microeconomics, macroeconomics and econometrics. PhD students from many Swiss universities take it for several weeks during their first year. They fly in very good professors from all over the world to teach us. It is a pretty amazing experience. Of course, you can also take other classes on top of that tailored to your research; there is a lot of flexibility.
Sounds like a great fit for you. So did the position come with funding or did you need to acquire your own funding?
It came with funding. In the first year, I received a grant from the university to complete the course requirements of the structured program. Starting from the second year, I was hired by the chair of Labor Economics as a teaching and research assistant.
That’s wonderful! Congratulations! In terms of research, it sounds like you are focused on labor as well as health economics, can you share more about the particular areas of research that you are looking at?
Yes, the common thread in the projects I’m working on for my thesis is moral hazard in social insurance, specifically in health and unemployment insurance. The key trade off there is balancing risk protection and incentive (or moral hazard) costs. In health insurance, for example, you want to give people sufficient financial protection in case they suffer an adverse health event, but you also don’t want them to overuse health care. Similarly in unemployment insurance, you want to support people if they lose their job, giving them sufficient time to find another suitable job, but you also want to maintain incentives to actively look for that job. My research aims to understand how individuals behave and respond to incentives in these systems, and how to optimally design these systems. There is quite a lot of research on this already, but I aim to elaborate on the dynamic aspects of individual decision-making, and to understand the sources and implications of heterogeneity across individuals in these systems.
What is your thesis project or what project are you working on currently?
I am currently working on my single-authored project called “Dynamic moral hazard in nonlinear health insurance contracts”. The goal is to understand the nature of moral hazard in health insurance. If you decrease the price individuals have to pay out-of-pocket for medical care (that is, increase the share the insurer pays), they can respond on two margins. First, they may consume more in total by getting more treatment than they would otherwise. Second, they may strategically schedule care for times when it is cheaper – reallocating their consumption in time but leaving the total unchanged. For example, if you have already exceeded your deductible this year, you might get a procedure today that you planned to do next year. These two margins of responses have different implications for collective healthcare spending and cost sharing between the insurer and the insured.
So looking back at both of your positions to date, you moved from a department that had a diverse range of researchers from many disciplines to an Economics department – was that challenging in any way?
It was interesting to spend time in both environments, but I think my current environment – an Economics department – is a better fit for completing my PhD. In my previous job, I was in a very interdisciplinary environment. This taught me to think about how we should convey economic research to other disciplines, which is not an easy task. Particularly in health economics, there are important behavioral, emotional and medical components to individual decision making, which are sometimes difficult to capture with classical economic models and tools. You have to be able to explain these ‘rational’ economic ideas to unfamiliar audiences. With this in mind, moving back to an Economics department for my PhD made sense for me to consolidate these tools and methods, economic theory and econometrics.
That will probably be quite interesting for people to hear, because they arrive in the institution in which they do their PhD via their own specific route, and maybe don’t have a full appreciation of the variety of pathways that one can take to get to where you are now.
Moving on, since you started the PhD, are there any particular challenges that you have faced that you can share with us?
Well, one challenge is that the end of the PhD seemed like a very abstract deadline at first. When you start, you have to figure out a lot of things on your own, such as how to manage your time, your energy, your own and others’ expectations, and how to track your progress. You quickly realize that a PhD is very much a marathon, not a sprint, and I learnt that it is ok to have a limited number of productive hours per day!
A second challenge is that I was given a lot of flexibility in my research agenda to develop ideas on my own. This is obviously great, and my supervisor is very available and supportive, but I had to learn how and when to really focus my energy to actually execute ideas. One way of doing that for me was to set myself deadlines to attend conferences quite early on. I really enjoy this part of academic work; getting out of the office and talking to other people.
I agree, it is a great opportunity to expose what you are thinking about, although for some it is quite a scary prospect as well, particularly if you don’t have too much experience of doing this in the past.
Looking back at your career pathway so far, is there anything that you would have done differently?
As I’m only just starting my third year, it is probably a little early for me to have any regrets! I am pretty happy with where I am right now. One of the things that I’m quite excited about is teaching more. I’m currently teaching a lab session on empirical research methods for Masters and PhD students. It’s fascinating to see things from the other side, and brings a new perspective to your own work. Ideally if there is time, I would also really like to get a stronger background in theoretical modelling, to be able to put my empirical results in a more formal and broader context and draw further policy implications.
Does your program have teaching requirements?
In the structured program I am in, after the first year of coursework you are hired as a teaching and research assistant at the faculty. This typically comes with some teaching responsibilities.
Have you had any thoughts yet on plans beyond the PhD?
Obviously I would like to become a Professor in a top Economics department! On a more serious note, I’m in the middle of my PhD at the moment and I’m trying to make the most out of it, so my planning horizon is currently a bit shorter. I’m about to start a new project, and I’m also starting to think about research visits for the last year of my PhD. This would allow me to expand my network, and to learn more about places that may be a good fit for me to continue my career. I also want to find out more about the academic job market.
At the iHEA Congress in Basel you were awarded the best paper prize in the ECR pre-congress session. We’re looking forward to seeing this paper in print at some point; could you update us on the current status of this paper?
I am very grateful for this award, and for the many helpful comments I received at iHEA. I’m currently rewriting the draft and finalizing the paper for submission, and hopefully I will be able to submit it very soon – the prize came with a fast-track publication option in Health Economics.
We will keep our fingers crossed that the editors and reviewers like the paper.
A final question from us: what do you do for fun, as we know the PhD experience can be quite intense?
I like to do sports. This is really important for me to clear my mind. I go running, I go to a boxing class, I have been skiing a lot too. I think it is important to be able to say that it’s enough for today, and that I’ll start again in the morning when I’m fresh.
Many thanks to Véra for talking to us today. Interested readers can learn more about Véra’s work by visiting her profile page. There will be an update on the next interview in the Early Career Researcher Interview Series in the coming weeks.