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Walking the Tightrope on Medicare Reform

  • David M. Cutler

A central controversy in the debate about Medicare is whether the program spends too much money or whether instead it should be expanded to cover more. I consider the value of increased Medicare spending. I argue that on average Medicare spending is worth it: the health gains brought by medicare have been greater than their cost. At the margin, however, services are overused and have low value. Medicare reforms need to promote the high average value of care while eliminating care of low value. Many of the proposed reforms fall short of this goal.

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File URL: http://www.aeaweb.org/articles.php?doi=10.1257/jep.14.2.45
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Article provided by American Economic Association in its journal Journal of Economic Perspectives.

Volume (Year): 14 (2000)
Issue (Month): 2 (Spring)
Pages: 45-56

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Handle: RePEc:aea:jecper:v:14:y:2000:i:2:p:45-56
Note: DOI: 10.1257/jep.14.2.45
Contact details of provider: Web page: https://www.aeaweb.org/jep/Email:


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  1. Viscusi, W Kip, 1993. "The Value of Risks to Life and Health," Journal of Economic Literature, American Economic Association, vol. 31(4), pages 1912-46, December.
  2. Rothschild, Michael & Stiglitz, Joseph E, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, MIT Press, vol. 90(4), pages 630-49, November.
  3. Fogel, Robert W, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," American Economic Review, American Economic Association, vol. 84(3), pages 369-95, June.
  4. David M. Cutler & Elizabeth Richardson, 1999. "Your Money and Your Life: The Value of Health and What Affects It," NBER Working Papers 6895, National Bureau of Economic Research, Inc.
  5. Dora L. Costa, 1998. "Understanding the Twentieth Century Decline in Chronic Conditions Among Older Men," NBER Working Papers 6859, National Bureau of Economic Research, Inc.
  6. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
  7. Samuel H. Preston, 1996. "American Longevity: Past, Present, and Future," Center for Policy Research Policy Briefs 7, Center for Policy Research, Maxwell School, Syracuse University.
  8. Laurence Baker & Joanne Spetz, 1999. "Managed Care and Medical Technology Growth," NBER Chapters, in: Frontiers in Health Policy Research, volume 2, pages 27-52 National Bureau of Economic Research, Inc.
  9. David M. Cutler, 1994. "A Guide to Health Care Reform," Journal of Economic Perspectives, American Economic Association, vol. 8(3), pages 13-29, Summer.
  10. David M. Cutler & Richard J. Zeckhauser, 1999. "The Anatomy of Health Insurance," NBER Working Papers 7176, National Bureau of Economic Research, Inc.
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