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The Lifetime Medical Spending of Retirees

Author

Listed:
  • Mariacristina De Nardi
  • Eric French
  • John Bailey Jones
  • Justin Kirschner
  • Rory McGee

Abstract

Using dynamic models of health, mortality, and out-of-pocket medical spending (both inclusive and net of Medicaid payments), we estimate the distribution of lifetime medical spending that retired US households face over the remainder of their lives. We find that households who turned 70 in 1992 will, on average, incur $122,000 in medical spending, including Medicaid payments, over their remaining lives. At the top tail, 5 percent of households will incur more than $300,000 and 1 percent of households will incur over $600,000 in medical spending inclusive of Medicaid. The level and the dispersion of this spending diminish only slowly with age. Although permanent income, initial health, and initial marital status have large effects on this spending, much of the dispersion in lifetime spending is due to events realized later in life. Medicaid covers the majority of the lifetime costs of the poorest households and significantly reduces their risk.

Suggested Citation

  • Mariacristina De Nardi & Eric French & John Bailey Jones & Justin Kirschner & Rory McGee, 2018. "The Lifetime Medical Spending of Retirees," Economic Quarterly, Federal Reserve Bank of Richmond, issue 3Q, pages 103-135.
  • Handle: RePEc:fip:fedreq:00060
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    File URL: https://www.richmondfed.org/-/media/richmondfedorg/publications/research/economic_quarterly/2018/q3/jones.pdf
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    References listed on IDEAS

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    1. Svetlana Pashchenko & Ponpoje Porapakkarm, 2013. "Quantitative Analysis of Health Insurance Reform: Separating Regulation from Redistribution," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 16(3), pages 383-404, July.
    2. Feenberg, Daniel & Skinner, Jonathan, 1994. "The Risk and Duration of Catastrophic Health Care Expenditures," The Review of Economics and Statistics, MIT Press, vol. 76(4), pages 633-647, November.
    3. James Banks & Richard Blundell & Peter Levell & James P. Smith, 2015. "Life-Cycle Consumption Patterns at Older Ages in the US and the UK Can Medical Expenditures Explain the Difference?," Working Papers WR-1100, RAND Corporation.
    4. Mariacristina De Nardi & Eric French & John B. Jones, 2010. "Why Do the Elderly Save? The Role of Medical Expenses," Journal of Political Economy, University of Chicago Press, vol. 118(1), pages 39-75, February.
    5. Jeffrey R. Brown & Amy Finkelstein, 2008. "The Interaction of Public and Private Insurance: Medicaid and the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 98(3), pages 1083-1102, June.
    6. Pashchenko, Svetlana, 2013. "Accounting for non-annuitization," Journal of Public Economics, Elsevier, vol. 98(C), pages 53-67.
    7. French Eric & Jones John Bailey & McCauley Jeremy, 2017. "The Accuracy of Economic Measurement in the Health and Retirement Study," Forum for Health Economics & Policy, De Gruyter, vol. 20(2), pages 1-16, December.
    8. John Ameriks & Joseph Briggs & Andrew Caplin & Matthew D. Shapiro & Christopher Tonetti, 2020. "Long-Term-Care Utility and Late-in-Life Saving," Journal of Political Economy, University of Chicago Press, vol. 128(6), pages 2375-2451.
    9. Eric French & John Bailey Jones, 2004. "On the distribution and dynamics of health care costs," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(6), pages 705-721.
    10. Anthony Webb & Natalia Zhivan, 2010. "How Much Is Enough? The Distribution of Lifetime Health Care Costs," Working Papers, Center for Retirement Research at Boston College wp2010-1, Center for Retirement Research, revised Feb 2010.
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    Cited by:

    1. Wouterse, B.; & Hussem, A.; & Wong, A.;, 2018. "The effect of co-payments in Long Term Care on the distribution of payments,consumption, and risk," Health, Econometrics and Data Group (HEDG) Working Papers 18/24, HEDG, c/o Department of Economics, University of York.

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    Keywords

    Medicaid; medical spending; retirees;

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