The Health Insurance Dynamics of Older Americans

描述(由申请人提供)：快速发展的健康技术有可能极大地改善美国老年人的健康。然而，技术进步伴随着成本的上升，这使得获得医疗保险对老年人的经济安全和生活质量都至关重要。尽管联邦医疗保险计划为65岁及以上的人提供了一套基本福利的几乎全民覆盖，但覆盖范围存在重大缺口。因此，大多数受益人能够并选择通过各种私人和公共计划来补充医疗保险。然而，受益人之间在可供选择的选择和他们获得的保险方面存在着相当大的差异。本研究的目的是考察影响老年医疗保险受益人补充保险选择的因素。该项目有两个具体目标：1)构建一个研究数据集，提供有关医疗保险受益人的健康、社会经济和人口特征以及他们可以获得的补充保险的类型和特征的详细信息；2)确定个人人口、健康和社会经济状况、市场趋势和医疗保险政策如何影响医疗保险受益人获得补充保险的机会。我将通过将健康和退休调查(HRS)的数据与外部数据源联系起来，根据受益人的个人特征和地理位置描述其补充保险的可用性和特点，从而实现第一个目标。我将通过使用研究数据集来估计医疗保险受益人的保险选择的多变量模型来实现第二个目标。这些模型将利用HRS中提供的纵向调查数据和详细而创新的调查问题来检查影响联邦医疗保险受益人补充保险选择的各种因素。如果我实现了这些目标，我将创建一个强大而独特的数据集，可以用来研究许多与老年人保险覆盖有关的问题，特别是在调查年份加入HRS的情况下。该项目将使我能够评估HRS中特定试验性问题对于健康保险选择模式的价值。此外，我还将就个人特征的影响提供新的证据，如健康状况和健康预期、认知能力、人口统计特征和社会经济地位，以及公共政策对保险选择的影响。

DESCRIPTION (provided by applicant): Rapidly advancing health technology has the potential to dramatically improve the health of older Americans. However, technological progress is accompanied by rising costs, making access to health insurance crucial for both the economic security and quality of life of the elderly. Although the Medicare program provides nearly universal coverage for a basic set of benefits for those aged 65 and older, the coverage has important gaps. As a result, most beneficiaries are able and choose to supplement Medicare through a variety of private and public programs. However, considerable variation exists among beneficiaries in the choices available to them and the coverage they obtain. The objective of this research is to examine the factors influencing elderly Medicare beneficiaries' supplemental coverage choices. The project has two specific aims: 1) to construct a study dataset that provides detailed information over time on both health, socioeconomic, and demographic characteristics of Medicare beneficiaries and the types and characteristics of supplemental coverage available to them; and 2) to determine how individual demographic, health, and socioeconomic status, market trends, and Medicare policies affect access to supplemental coverage among Medicare beneficiaries. I will achieve the first objective by linking data from the Health and Retirement Survey (HRS) with external data sources describing the availability and features of supplemental coverage for Medicare beneficiaries based on both their individual characteristics and their geographic location. I will achieve the second objective by using the study dataset to estimate multivariate models of insurance choices among Medicare beneficiaries. These models will take advantage of the longitudinal survey data and detailed and innovative survey questions available in the HRS to examine a variety of factors affecting Medicare beneficiary supplemental coverage choices. If I achieve these objectives, I will have created a powerful and unique dataset that can be used to examine many issues related to the insurance coverage of the elderly, particularly as survey years are added to the HRS. The project will allow me to assess the value of particular experimental question in the HRS for models of health insurance choices. In addition, I will have provided new evidence regarding the influence of individual characteristics such as health status and health expectations, cognitive ability, demographic characteristics and socioeconomic status and the effects of public policies on coverage choices.