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，目前尚不清楚的是，为65岁以上的美国人提供近乎全民覆盖的医疗保险计划是否可能拯救那些在接近老年时缺乏保险的人，或者可能为这一群体提供的保险太少，为时已晚。鉴于25%的近老年人将经历一段没有保险的时期，理清健康保险与老年健康之间的关系可能会带来重要的政策干预措施，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否更有可能发生在65岁之前没有医疗保险的老年人中，或者是否在所有医疗保险受益人中同样发生。这项研究将告知将医疗保险扩展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，以配合社会保障资格年龄的提高，这项研究将 这也为一项更直接的政策提供了信息：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？数据来源将是健康与退休研究（HRS），这是一项正在进行的小组调查，调查对象是1992年研究开始时年龄在51-61岁之间的12，562名具有全国代表性的人群。他们的反应将与他们的医疗保险索赔联系在一起。将对健康结果和医疗服务使用的广泛措施进行评估。之前和之后65健康轨迹和医疗服务使用模式的变化将估计整个样本和保险状态亚组。还将估计组间这些变化的差异。我们将使用这些估计来模拟医疗保险资格年龄的变化对健康，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.