Life Cycle Effects of Health Insurance on Elderly Health

描述(由申请人提供)：研究表明，医疗保险改善了老年人的健康状况。然而，尚不清楚的是，为65岁以上的美国人提供近乎全民覆盖的联邦医疗保险计划，是在拯救那些在接近老年时缺乏保险的人，还是为这一群体提供的覆盖范围太晚了。鉴于25%的近老年人将经历一段没有保险的时期，理清医疗保险与老年健康之间的关系，可能会导致重要的政策干预，以改善老年人的健康。该项目的主要目的是研究这些改善是更有可能发生在65岁有资格享受联邦医疗保险之前没有保险的老年人中，还是在所有联邦医疗保险受益人中平等发生。这项研究将告知，将医疗保险扩大到难以获得医疗保险的近老年人的政策是否会改善他们进入老年的健康轨迹。鉴于医疗保险计划正面临破产，可能不得不考虑提高资格年龄，以与提高领取社会保障的资格年龄相一致，这项研究将 还告知更直接关注的政策：获得医疗保险资格年龄的变化将如何改变老年人的健康和医疗服务使用？数据来源将是健康和退休研究(HRS)，这是一项正在进行的小组调查，对象是全国有代表性的12562人，他们在1992年研究开始时年龄在51-61岁之间。回复将与他们的联邦医疗保险索赔挂钩。将对健康结果和医疗服务使用的广泛衡量标准进行评估。65年前和65年后，将估计整个样本和保险状况分组的健康轨迹和医疗服务使用模式的变化。还将估计不同组之间这些变化的差异。我们将使用这些估计来模拟医疗保险资格年龄变化对健康、医疗服务使用和医疗保险支出的影响。

DESCRIPTION (provided by applicant): Studies suggest Medicare insurance has improved health outcomes for the elderly. However, what is unknown is whether the Medicare program, which provides near universal coverage for Americans over 65, may be rescuing those who lacked insurance while near-elderly or may be providing too little coverage too late for this group. Given that 25% of the near-elderly will experience a period without insurance, sorting out this relationship between health insurance and health in old age, could lead to important policy interventions to improve the health of the elderly. The principal aim of this project is to study whether these improvements ire more likely to occur among the elderly who were uninsured prior to qualifying for Medicare at age 65 or whether they occur equally among all Medicare beneficiaries. This study will inform whether a policy to extend Medicare to the near-elderly who have difficulty obtaining health insurance would improve their health trajectories into old age. Given that the Medicare program is facing insolvency and may have to consider raising the eligibility age to coincide with the increase in the eligibility age for Social Security, this study will also inform a policy of more immediate concern: how would changes in the age of eligibility for Medicare change health and medical service use of the elderly? The data source will be the Health and Retirement Study (HRS), which is an ongoing panel survey of a nationally representative cohort of 12,562 individuals who were 51-61 years old when the study started in 1992. Responses will be linked with their Medicare claims. A broad range of measures of health outcomes and medical service use will be evaluated. Before and after 65 changes in health trajectories and medical service use patterns will be estimated for the entire sample and for insurance status subgroups. Differences in these changes between groups will also be estimated. We will use these estimates to simulate the effect of changes in the age of Medicare eligibility on health, medical service use and Medicare expenditure.