Regional Inequality in Medicare Spending: The Key to Medicare Reform?
Medicare expenditures per capita vary widely across different parts of the country. Average fee-for-service per capita expenditures in 1995/96 were $3,420 in Eugene, Oregon, $3,663 in Minneapolis, $7,847 in Miami, and $8,861 in McAllen, Texas. These measures are adjusted for differences across regions in the age, sex, and racial composition of the population, as well as differences in the underlying cost of healthcare. In this paper, we focus on these geographical variations in the Medicare program and argue that they are central to any proposed reform of the Medicare system. The first question that must be addressed is, are these expenditures higher in high-cost areas because the elderly population there is sicker? The answer is, largely no. Many of the areas with the highest levels of spending have similar underlying disease burdens to regions with low levels of spending. Nor does quality of care or patient satisfaction appear to be better in the high-expenditure areas. These disparities bring up a number of issues related to equity across regions, efficiency of Medicare spending, and the potential for funding Medicare reform. Reducing the intensity of care in high-expenditure regions can fund prescription drug benefits for the entire Medicare population, or extend the solvency of the Medicare trust funds by ten years, without obvious adverse implications for the health or satisfaction of the elderly population.
If 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.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 3 (2000)
Issue (Month): 1 (January)
|Contact details of provider:|| Web page: http://www.degruyter.com|
|Order Information:||Web: http://www.degruyter.com/view/j/fhep|
When requesting a correction, please mention this item's handle: RePEc:bpj:fhecpo:v:3:y:2000:n:4. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Peter Golla)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.