What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending
What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending
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DOI：
10.1016/j.jpubeco.2007.10.005
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发表时间：
2008-07-01
影响因子：
9.8
通讯作者：
McKnight, Robin
中科院分区：
文献类型：
--
作者：
Finkelstein, Amy;McKnight, Robin
我们研究了美国社会保险制度的主要支柱之一：1965年引入医疗保险的影响。我们的研究结果表明，在最初的10年里，为老年人建立全民健康保险对老年人死亡率没有明显的影响。然而，我们发现老年人的自付医疗支出风险大大降低。具体来说，我们估计，医疗保险的引入与自付支出分布的前四分之一的自付支出下降40%有关。程式化的预期效用框架表明，仅风险敞口的减少所带来的福利收益就足以覆盖医疗保险成本的近五分之二。这些发现强调了考虑公共健康保险计划的直接保险利益以及对健康影响的任何间接利益的重要性。(c)2007 Elsevier B.V.保留所有权利。
We study the impact of the introduction of one of the major pillars of the social insurance system in the United States: the introduction of Medicare in 1965. Our results suggest that, in its first 10 years, the establishment of universal health insurance for the elderly had no discernible impact on elderly mortality. However, we find a substantial reduction in the elderly's exposure to out of pocket medical expenditure risk. Specifically, we estimate that the introduction of Medicare was associated with a 40% decline in out of pocket spending for the top quartile of the out of pocket spending distribution. A stylized expected utility framework suggests that the welfare gains from such reductions in risk exposure alone may be sufficient to cover almost two-fifths of the costs of Medicare. These findings underscore the importance of considering the direct insurance benefits from public health insurance programs, in addition to any indirect benefits from an effect on health. (c) 2007 Elsevier B.V. All rights reserved.