Recent innovations in representative bureaucracy push the theory toward the micro-foundations of who represents and who receives representation. Contributing to the micro theory, I draw from street-level bureaucracy which recognizes how certain client characteristics beyond a shared identity may make representation too costly. Using data on emergency department visits to Florida hospitals, I explore how the impact of physician-patient gender matching on client outcomes is moderated by a patient's insurance status. While emergency departments offer universal, public access, services performed on publicly insured and uninsured individuals are reimbursed at a lower rate than the privately insured. These features present an opportunity to test how responsive representation is to different client costs and benefits. The findings suggest that public insurance status is not a barrier for women's representation. However, uninsured women do not see any improvement in outcomes when receiving representation.

中文翻译：

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代理成本：急诊科护理中的保险状况、性别和心脏结果

代议制官僚机构的最新创新将理论推向了谁代表和谁接受代表的微观基础。为微观理论做出贡献，我借鉴了街头官僚机构，它认识到某些客户特征超出共享身份可能会使代表成本过高。使用佛罗里达医院急诊科就诊的数据，我探索了医患性别匹配对客户结果的影响如何通过患者的保险状态来调节。虽然急诊部门提供普遍的公共访问服务，但为公共保险和未保险个人提供的服务的报销率低于私人保险人。这些功能提供了一个机会来测试响应对不同客户成本和收益的响应。调查结果表明，公共保险状况并不是女性代表的障碍。然而，未参保的女性在接受代理后并没有看到结果有任何改善。