The Distributional Effects of Medicare
AbstractThe Medicare program is now an important source of transfers to elderly and disabled beneficiaries, and will continue to grow rapidly in the future. Because the Medicare program is so large in magnitude, it can have significant redistributional effects. In this paper, we measure the flow of Medicare benefits to high-income and low-income neighborhoods in 1990 and 1995. We find that Medicare spending per capita for the lowest income groups grew much more rapidly than Medicare spending in either high income or middle income neighborhoods. Home health care spending played an important role in the increased spending among the lowest income neighborhoods. To our knowledge, this differential shift in spending has not been documented, yet it exceeds in magnitude the entire per capita transfer from the Earned Income Tax Credit (EITC) and is half of the average transfers to the elderly poor from Supplemental Security Income (SSI). Recent cutbacks in home health care benefits may undo some of this change. Still, this example illustrates how specific technical changes in Medicare policy can have redistributional effects comparable to major and much more visible expenditure and tax policies.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6910.
Date of creation: Jan 1999
Date of revision:
Publication status: published as Julie Lee, Mark McClellan, Jonathan Skinner. "The Distributional Effects of Medicare," in James M. Poterba, editor, "Tax Policy and the Economy, volume 13" MIT Press (1999)
Contact details of provider:
Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
Web page: http://www.nber.org
More information through EDIRC
Other versions of this item:
- H5 - Public Economics - - National Government Expenditures and Related Policies
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
This paper has been announced in the following NEP Reports:
- NEP-ALL-1999-02-08 (All new papers)
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.:
- McClellan, Mark & Skinner, Jonathan, 2006.
"The incidence of Medicare,"
Journal of Public Economics,
Elsevier, vol. 90(1-2), pages 257-276, January.
- Mark G. Duggan, 2000.
"Hospital Ownership And Public Medical Spending,"
The Quarterly Journal of Economics,
MIT Press, vol. 115(4), pages 1343-1373, November.
- Victor R. Fuchs, 1998. "Provide, Provide: The Economics of Aging," NBER Working Papers 6642, National Bureau of Economic Research, Inc.
- Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1991.
"Social Security and Medicare Policy From the Perspective of Generational Accounting,"
NBER Working Papers
3915, National Bureau of Economic Research, Inc.
- Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1992. "Social Security and Medicare Policy from the Perspective of Generational Accounting," NBER Chapters, in: Tax Policy and the Economy, Volume 6, pages 129-145 National Bureau of Economic Research, Inc.
- Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1992. "Social security and Medicare policy from the perspective of generational accounting," Working Paper 9206, Federal Reserve Bank of Cleveland.
- 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.
- Charles R. Link & Stephen H. Long & Russell F. Settle, 1982. "Equity and the Utilization of Health Care Services by the Medicare Elderly," Journal of Human Resources, University of Wisconsin Press, vol. 17(2), pages 195-212.
- Panis, C.W.A. & Lillard, L.A., 1996. "Socioeconomic Differentials in the Returns to Social Security," Papers 96-05, RAND - Labor and Population Program.
- Jagadeesh Gokhale & Kent Smetters, 2003. "Fiscal and generational imbalances: new budget measures for new budget priorities," Policy Discussion Papers, Federal Reserve Bank of Cleveland, issue Dec.
- Jay Bhattacharya & Darius Lakdawalla, 2002. "Does Medicare Benefit the Poor? New Answers to an Old Question," NBER Working Papers 9280, National Bureau of Economic Research, Inc.
- Mark McClellan, 2000. "Medicare Reform: Fundamental Problems, Incremental Steps," Journal of Economic Perspectives, American Economic Association, vol. 14(2), pages 21-44, Spring.
- Robert Rosenman, 2011.
"The public finance of healthy behavior,"
Springer, vol. 147(1), pages 173-188, April.
- Orsini, Chiara, 2010. "Changing the way the elderly live: Evidence from the home health care market in the United States," Journal of Public Economics, Elsevier, vol. 94(1-2), pages 142-152, February.
- Grabowski, David C. & Gruber, Jonathan, 2007. "Moral hazard in nursing home use," Journal of Health Economics, Elsevier, vol. 26(3), pages 560-577, May.
- Mark McClellan & Jonathan Skinner, 1997.
"The Incidence of Medicare,"
NBER Working Papers
6013, National Bureau of Economic Research, Inc.
- Amitabh Chandra & Jonathan Skinner, 2003. "Geography and Racial Health Disparities," NBER Working Papers 9513, National Bureau of Economic Research, Inc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ().
If references are entirely missing, you can add them using this form.