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Medicare and the Health of Women with Breast Cancer

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  • Sandra L. Decker

Abstract

This paper investigates the effect of health insurance on health and the use of health services by exploiting a change in insurance status that occurs for most Americans at age 65; that is, eligibility for the U.S. Medicare program. A regression discontinuity design is employed to identify discontinuities at age 65 in the relationship between age and access to care and health status, especially for groups more likely to be uninsured prior to age 65, such as those with less than a high school education or blacks and Hispanics. The paper focuses on the use of health services and health outcome related to breast cancer, a common cause of death among women, and one for which good access to early detection services is thought to significantly improve survival. Results show that the use of health services including mammography increases discontinuously at age 65, especially for women without a high school degree and for black and Hispanic women. A modest decrease in the probability of late-stage breast cancer diagnosis at age 65 is also found for white and Hispanic women.

Suggested Citation

  • Sandra L. Decker, 2005. "Medicare and the Health of Women with Breast Cancer," Journal of Human Resources, University of Wisconsin Press, vol. 40(4), pages 948-968.
  • Handle: RePEc:uwp:jhriss:v:40:y:2005:i:4:p:948-968
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    References listed on IDEAS

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    1. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," NBER Working Papers 10365, National Bureau of Economic Research, Inc.
    2. Michael Baker & Mark Stabile & Catherine Deri, 2004. "What Do Self-Reported, Objective, Measures of Health Measure?," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
    3. Brian A. Jacob & Lars Lefgren, 2004. "Remedial Education and Student Achievement: A Regression-Discontinuity Analysis," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 226-244, February.
    4. Lemieux, Thomas & Milligan, Kevin, 2008. "Incentive effects of social assistance: A regression discontinuity approach," Journal of Econometrics, Elsevier, vol. 142(2), pages 807-828, February.
    5. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," NBER Working Papers 10365, National Bureau of Economic Research, Inc.
    6. Dwyer, Debra Sabatini & Mitchell, Olivia S., 1999. "Health problems as determinants of retirement: Are self-rated measures endogenous?," Journal of Health Economics, Elsevier, vol. 18(2), pages 173-193, April.
    7. Jonathan Skinner & Weiping Zhou, 2004. "The Measurement and Evolution of Health Inequality: Evidence from the U.S. Medicare Population," NBER Working Papers 10842, National Bureau of Economic Research, Inc.
    8. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health Evidence from Medicare," Working Papers WR-197, RAND Corporation.
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    Cited by:

    1. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
    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. Witman, Allison, 2015. "Public health insurance and disparate eligibility of spouses: The Medicare eligibility gap," Journal of Health Economics, Elsevier, vol. 40(C), pages 10-25.
    4. Tamie Matsuura & Masaru Sasaki, 2012. "Can the health insurance reforms stop an increase in medical expenditures for middle- and old-aged persons in Japan?," International Journal of Health Economics and Management, Springer, vol. 12(2), pages 163-187, June.
    5. Shao-Hsun Keng & Shin-Yi Wu, 2014. "Living Happily Ever After? The Effect of Taiwan’s National Health Insurance on the Happiness of the Elderly," Journal of Happiness Studies, Springer, vol. 15(4), pages 783-808, August.
    6. Yingying Dong, 2013. "How Health Insurance Affects Health Care Demand—A Structural Analysis Of Behavioral Moral Hazard And Adverse Selection," Economic Inquiry, Western Economic Association International, vol. 51(2), pages 1324-1344, April.

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