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Estimating willingness to pay for medicare using a dynamic life-cycle model of demand for health insurance

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  • Khwaja, Ahmed
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    Abstract

    Medicare is the largest health insurance program in the US. This paper uses a dynamic random utility model of demand for health insurance in a life-cycle human capital framework with endogenous production of health to calculate the individual willingness to pay (WTP) for Medicare. The model accounts for the feature that the demand for health insurance is derived through the demand for health, which is jointly determined with the production of health over the life-cycle. The WTP measure incorporates the effects of Medicare insurance on aggregate consumption through effects on medical expenditures and mortality, and consumption utility of health. The model is estimated using panel data from the Health and Retirement Study. The average WTP or change in lifetime expected utility resulting from delaying the age of eligibility to 67 is found to be $ 24,947 in 1991 dollars ($ 39,435 in 2008 dollars). However, there is considerable variation in the WTP, e.g., in 1991 dollars the WTP of individuals who have less than a high school education and are white is $ 28,347 ($ 44,810 in 2008 dollars), while the WTP of those with at least a college degree and who are neither white nor black is $ 15,584 ($ 24,635 in 2008 dollars). More generally, the less educated have a higher WTP to avoid a policy change that delays availability of Medicare benefits. Additional model simulations imply that the primary benefits of Medicare are insurance against medical expenditures with relatively smaller benefits in terms of improved health status and longevity. Medicare also leads to large increases in medical utilization due to deferring of medical care prior to eligibility.

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    Bibliographic Info

    Article provided by Elsevier in its journal Journal of Econometrics.

    Volume (Year): 156 (2010)
    Issue (Month): 1 (May)
    Pages: 130-147

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    Handle: RePEc:eee:econom:v:156:y:2010:i:1:p:130-147

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    Web page: http://www.elsevier.com/locate/jeconom

    Related research

    Keywords: Medicare Willingness to pay Life-cycle human capital Dynamic discrete choice;

    References

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    Cited by:
    1. Mariacristina De Nardi & Eric French & John Bailey Jones, 2013. "Medicaid Insurance in Old Age," NBER Working Papers 19151, National Bureau of Economic Research, Inc.
    2. Mariacristina De Nardi & Eric French & John Bailey Jones, 2009. "Why do the Elderly Save? The Role of Medical Expenses," NBER Working Papers 15149, National Bureau of Economic Research, Inc.
    3. Mariacristina De Nardi & Eric French & John Bailey Jones, 2010. "The Effects of Medicaid and Medicare Reforms on the Elderly’s Savings and Medical Expenditures," Working Papers wp236, University of Michigan, Michigan Retirement Research Center.
    4. Raquel Fonseca & Pierre-Carl Michaud & Arie Kapteyn & Titus Galama, 2013. "Accounting for the Rise of Health Spending and Longevity," Cahiers de recherche 1326, CIRPEE.
    5. Gilleskie, Donna, 2010. "Work absences and doctor visits during an illness episode: The differential role of preferences, production, and policies among men and women," Journal of Econometrics, Elsevier, vol. 156(1), pages 148-163, May.

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