Medical Spending of the US Elderly
Medical Spending of the US Elderly
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DOI：
10.1111/j.1475-5890.2016.12106
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发表时间：
2016-09-01
期刊：
影响因子：
7.3
通讯作者：
McCauley, Jeremy
中科院分区：
文献类型：
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作者：
De Nardi, Mariacristina;French, Eric;McCauley, Jeremy
我们使用来自医疗保险当前受益人调查（MCBS）的数据来记录65岁及以上美国人的医疗支出。我们发现，70岁至90岁之间的医疗费用增加了一倍多，而且非常集中：所有支出者中收入最高的10%承担了特定年份52%的医疗费用。此外，那些目前经历非常低或非常高的医疗费用的人可能会发现自己在未来处于同样的位置。我们还发现，穷人比富人消费更多的医疗产品和服务，政府支付的费用比例也大得多。总的来说，政府支付老年人65%以上的医疗费用。尽管如此，政府转移支付后剩下的费用更集中在一小部分人身上。因此，政府医疗保险虽然可能非常有价值，但远未完成。最后，虽然死前的医疗费用可能很大，但平均而言，无论是在总体上还是在整个生命周期中，它们都只占总支出的一小部分。因此，死亡前的医疗费用似乎并不是美国医疗费用高企和不断增长的重要驱动力。
We use data from the Medicare Current Beneficiary Survey (MCBS) to document the medical spending of Americans aged 65 and older. We find that medical expenses more than double between ages 70 and 90 and that they are very concentrated: the top 10 per cent of all spenders are responsible for 52 per cent of medical spending in a given year. In addition, those currently experiencing either very low or very high medical expenses are likely to find themselves in the same position in the future. We also find that the poor consume more medical goods and services than the rich and have a much larger share of their expenses covered by the government. Overall, the government pays for over 65 per cent of the elderly's medical expenses. Despite this, the expenses that remain after government transfers are even more concentrated among a small group of people. Thus, government health insurance, while potentially very valuable, is far from complete. Finally, while medical expenses before death can be large, on average they constitute only a small fraction of total spending, both in the aggregate and over the life cycle. Hence, medical expenses before death do not appear to be an important driver of the high and increasing medical spending found in the US.