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Walking the Tightrope on Medicare Reform

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  • David M. Cutler

Abstract

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.

Suggested Citation

  • David M. Cutler, 2000. "Walking the Tightrope on Medicare Reform," Journal of Economic Perspectives, American Economic Association, vol. 14(2), pages 45-56, Spring.
  • Handle: RePEc:aea:jecper:v:14:y:2000:i:2:p:45-56
    Note: DOI: 10.1257/jep.14.2.45
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    File URL: http://www.aeaweb.org/articles.php?doi=10.1257/jep.14.2.45
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    References listed on IDEAS

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    1. 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.
    2. Michael Rothschild & Joseph Stiglitz, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, Oxford University Press, vol. 90(4), pages 629-649.
    3. Viscusi, W Kip, 1993. "The Value of Risks to Life and Health," Journal of Economic Literature, American Economic Association, vol. 31(4), pages 1912-1946, December.
    4. David M. Cutler, 1994. "A Guide to Health Care Reform," Journal of Economic Perspectives, American Economic Association, vol. 8(3), pages 13-29, Summer.
    5. David M. Cutler & Elizabeth Richardson, 1999. "Your Money and Your Life: The Value of Health and What Affects It," NBER Chapters, in: Frontiers in Health Policy Research, volume 2, pages 99-132, National Bureau of Economic Research, Inc.
    6. Dora Costa, 2000. "Understanding the twentieth-century decline in chronic conditions among older men," Demography, Springer;Population Association of America (PAA), vol. 37(1), pages 53-72, February.
    7. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.),Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    8. 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.
    9. 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 369-395, June.
    10. 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.
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    Citations

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    Cited by:

    1. Louise Sheiner & David M. Cutler, 2000. "Generational Aspects of Medicare," American Economic Review, American Economic Association, vol. 90(2), pages 303-307, May.
    2. Khwaja, Ahmed, 2010. "Estimating willingness to pay for medicare using a dynamic life-cycle model of demand for health insurance," Journal of Econometrics, Elsevier, vol. 156(1), pages 130-147, May.
    3. Roger D. Congleton & Alberto Batinti & Rinaldo Pietratonio, 2017. "The Electoral Politics and the Evolution of Complex Healthcare Systems," Kyklos, Wiley Blackwell, vol. 70(4), pages 483-510, November.
    4. Sherry Glied, 2003. "Health Care Costs: On the Rise Again," Journal of Economic Perspectives, American Economic Association, vol. 17(2), pages 125-148, Spring.
    5. Jonathan S. Skinner & Elliott S. Fisher & John Wennberg, 2005. "The Efficiency of Medicare," NBER Chapters, in: Analyses in the Economics of Aging, pages 129-160, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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