We thank Julie Shi, Joe Price, Yuli Xu, and audiences at the International Health Economics Association 2025 and American Economics Association 2026 conferences for comments and reactions that have improved this paper. Ted Telford initiated the data collection underlying this work. Support from National Institutes of Health (NICHD) through Award HD 042731-01 is gratefully acknowledged (Shiue). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.