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Does Medicare Save Lives?

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Author Info
David Card (University of California, Berkeley.)
Carlos Dobkin (University of California, Santa Cruz.)
Nicole Maestas (RAND Corporation.)

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Abstract

Health insurance characteristics shift at age 65 as most people become eligible for Medicare. We measure the impacts of these changes on patients who are admitted to hospitals through emergency departments for conditions with similar admission rates on weekdays and weekends. The age profiles of admissions and comorbidities for these patients are smooth at age 65, suggesting that the severity of illness is similar on either side of the Medicare threshold. In contrast, the number of procedures performed in hospitals and total list charges exhibit small but statistically significant discontinuities, implying that patients over 65 receive more services. We estimate a nearly 1-percentage-point drop in 7-day mortality for patients at age 65, equivalent to a 20% reduction in deaths for this severely ill patient group. The mortality gap persists for at least 9 months after admission. (c) 2009 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology..

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File URL: http://www.mitpressjournals.org/doi/pdfplus/10.1162/qjec.2009.124.2.597
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Publisher Info
Article provided by MIT Press in its journal Quarterly Journal of Economics.

Volume (Year): 124 (2009)
Issue (Month): 2 (May)
Pages: 597-636
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Handle: RePEc:tpr:qjecon:v:124:y:2009:i:2:p:597-636

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," Working Papers 197, RAND Corporation Publications Department. [Downloadable!]
    Other versions:
  2. Currie, Janet & Gruber, Jonathan, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 431-66, May. [Downloadable!] (restricted)
    Other versions:
  3. Christopher J. Ruhm, 2000. "Are Recessions Good For Your Health?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 617-650, May. [Downloadable!] (restricted)
    Other versions:
  4. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December. [Downloadable!] (restricted)
  5. Frank Lichtenberg, 2002. "The Effects of Medicare on Health Care Utilization and Outcomes," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 5(1), pages 1028-1028. [Downloadable!] (restricted)
  6. Amy Finkelstein & Robin McKnight, 2005. "What Did Medicare Do (And Was It Worth It)?," NBER Working Papers 11609, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. David H. Autor & Mark G. Duggan, 2003. "The Rise In The Disability Rolls And The Decline In Unemployment," The Quarterly Journal of Economics, MIT Press, vol. 118(1), pages 157-205, February. [Downloadable!] (restricted)
  8. Sandra L. Decker & Carol Rapaport, 2002. "Medicare And Inequalities In Health Outcomes: The Case Of Breast Cancer," Contemporary Economic Policy, Western Economic Association International, vol. 20(1), pages 1-11, 01. [Downloadable!] (restricted)
  9. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June. [Downloadable!] (restricted)
  10. David Cutler & Mark McClellan & Joseph Newhouse, 1998. "The Costs and Benefits of Intensive Treatment for Cardiovascular Disease," NBER Working Papers 6514, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  11. Joseph P. Newhouse, 2004. "Pricing the Priceless: A Health Care Conundrum," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262640589.
  12. Guido Imbens & Thomas Lemieux, 2007. "Regression Discontinuity Designs: A Guide to Practice," NBER Working Papers 13039, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  13. Sandra Decker & Carol Rapaport, 2002. "Medicare and Disparities in Women's Health," NBER Working Papers 8761, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  14. Justin McCrary, 2007. "Manipulation of the Running Variable in the Regression Discontinuity Design: A Density Test," NBER Technical Working Papers 0334, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  15. Joseph P. Newhouse, 1996. "Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1236-1263, September. [Downloadable!] (restricted)
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  1. Hullegie, P & Klein, T. J, 2009. "The effect of private health insurance on medical care utilization and self-assessed health in Germany," Health, Econometrics and Data Group (HEDG) Working Papers 09/17, HEDG, c/o Department of Economics, University of York. [Downloadable!]
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