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Medical Spending in the US: Facts from the Medical Expenditure Panel Survey Data Set

Author

Listed:
  • Eric French
  • Elaine Kelly
  • Svetlana Pashchenko
  • Ponpoje Porapakkarm

Abstract

We document facts about medical spending of the US population using the Medical Expenditure Panel Survey dataset. We find that for the entire population, around 44% of the total medical spending is paid by private insurance but there is a substantial difference in terms of financing medical care by age: for working age adults (25 to 65 years old) private insurance covers around 57% of the total medical spending, whereas for the elderly (older than 65 years old) the largest payor is the government which covers 65% of the total. Inpatient hospital care accounts for a third of the aggregate medical expenditures. Medical spending is highly concentrated: the top 5% of spenders account for more than half of the total expenditure. Even higher concentration is observed among hospital spending where the top 5% of spenders contribute around 80% to the total expenditure. The concentration in medical spending decreases with age: the Gini coefficient of the total medical spending is 0.75 for people aged between 25 and 64 years old and 0.63 for people older than 65 years old. We find that average medical spending of people in the bottom income quintile is higher than that of people in the top income quintile for all age groups. In terms of persistence of medical spending, we find that the correlation of medical expenditure in two consecutive years is 0.36. When persistence is measured by quintile of medical spending distribution, medical spending of people in the bottom and top quintiles has higher persistence relative to other groups.
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Suggested Citation

  • Eric French & Elaine Kelly & Svetlana Pashchenko & Ponpoje Porapakkarm, 2016. "Medical Spending in the US: Facts from the Medical Expenditure Panel Survey Data Set," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 689-716, September.
  • Handle: RePEc:ifs:fistud:v:37:y:2016:i::p:689-716
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    Citations

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    Cited by:

    1. Svetlana Pashchenko & Ponpoje Porapakkarm, 2024. "Accounting For Social Security Claiming Behavior," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 65(1), pages 505-545, February.
    2. Pashchenko, Svetlana & Porapakkarm, Ponpoje, 2020. "Saving Motives over the Life-Cycle," MPRA Paper 100208, University Library of Munich, Germany.
    3. Mariacristina De Nardi & Svetlana Pashchenko & Ponpoje Porapakkarm, 2025. "The Lifetime Costs of Bad Health," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 92(3), pages 1987-2026.
    4. Eric French & Hans-Martin von Gaudecker & John Bailey Jones, 2016. "The Effect of the Affordable Care Act on the Labor Supply, Savings, and Social Security of Older Americans," Working Papers wp354, University of Michigan, Michigan Retirement Research Center.
    5. Jorge Luis Garcia & Frederik Bennhoff & Duncan Ermini Leaf & James J. Heckman, 2021. "The Dynastic Benefits of Early Childhood Education," Working Papers 2021-033, Human Capital and Economic Opportunity Working Group.
    6. 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.
    7. Frederik H. Bennhoff & Jorge Luis García & Duncan Ermini Leaf, 2024. "The Dynastic Benefits of Early-Childhood Education: Participant Benefits and Family Spillovers," Journal of Human Capital, University of Chicago Press, vol. 18(1), pages 44-73.
    8. Karolos Arapakis & Eric French & John Bailey Jones & Jeremy McCauley, 2021. "On the Distribution and Dynamics of Medical Expenditure Among the Elderly," Working Papers wp436, University of Michigan, Michigan Retirement Research Center.
    9. Svetlana Pashchenko & Ponpoje Porapakkarm, 2017. "Work Incentives Of Medicaid Beneficiaries And The Role Of Asset Testing," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 58(4), pages 1117-1154, November.
    10. Karolos Arapakis & Eric French & John Bailey Jones & Jeremy McCauley, 2022. "How Redistributive Are Public Health Care Schemes? Evidence from Medicare and Medicaid in Old Age," Working Papers wp441, University of Michigan, Michigan Retirement Research Center.
    11. Youngsoo Jang & Svetlana Pashchenko & Ponpoje Porapakkarm, 2025. "Redistribution, distortions, and the welfare effects of Social Security," Working papers 2025rwp-271, Yonsei University, Yonsei Economics Research Institute.
    12. Svetlana Pashchenko & Ponpoje Porapakkarm, 2019. "Reducing Medical Spending of the Publicly Insured: The Case for a Cash-out Option," American Economic Journal: Economic Policy, American Economic Association, vol. 11(3), pages 390-426, August.
    13. Eric French & Elaine Kelly & Mariacristina Nardi & Eric French & John Bailey Jones & Jeremy McCauley, 2016. "Medical Spending of the US Elderly," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 717-747, September.

    More about this item

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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