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Two Hundred Years of Health and Medical Care: The Importance of Medical Care for Life Expectancy Gains

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  • Maryaline Catillon
  • David Cutler
  • Thomas Getzen

Abstract

Using two hundred years of national and Massachusetts data on medical care and health, we examine how central medical care is to life expectancy gains. While common theories about medical care cost growth stress growing demand, our analysis highlights the importance of supply side factors, including the major public investments in research, workforce training and hospital construction that fueled a surge in spending over the 1955-1975 span. There is a stronger case that personal medicine affected health in the second half of the twentieth century than in the preceding 150 years. Finally, we consider whether medical care productivity decreases over time, and find that spending increased faster than life expectancy, although the ratio stabilized in the past two decades.

Suggested Citation

  • Maryaline Catillon & David Cutler & Thomas Getzen, 2018. "Two Hundred Years of Health and Medical Care: The Importance of Medical Care for Life Expectancy Gains," NBER Working Papers 25330, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:25330
    Note: AG DAE DEV HC HE PE
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    References listed on IDEAS

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    1. Daron Acemoglu & David Cutler & Amy Finkelstein & Joshua Linn, 2006. "Did Medicare Induce Pharmaceutical Innovation?," American Economic Review, American Economic Association, vol. 96(2), pages 103-107, May.
    2. David M. Cutler, 2008. "Are We Finally Winning the War on Cancer?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 3-26, Fall.
    3. Lindert, Peter H. & Williamson, Jeffrey G., 2013. "American Incomes Before and After the Revolution," The Journal of Economic History, Cambridge University Press, vol. 73(3), pages 725-765, September.
    4. Alice Chen & Dana Goldman, 2016. "Health Care Spending: Historical Trends and New Directions," Annual Review of Economics, Annual Reviews, vol. 8(1), pages 291-319, October.
    5. Robert E. Hall & Charles I. Jones, 2007. "The Value of Life and the Rise in Health Spending," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 39-72.
    6. 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.
    7. Marcella Alsan & Claudia Goldin, 2019. "Watersheds in Child Mortality: The Role of Effective Water and Sewerage Infrastructure, 1880–1920," Journal of Political Economy, University of Chicago Press, vol. 127(2), pages 586-638.
    8. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    9. Thomasson, Melissa A. & Treber, Jaret, 2008. "From home to hospital: The evolution of childbirth in the United States, 1928-1940," Explorations in Economic History, Elsevier, vol. 45(1), pages 76-99, January.
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    Cited by:

    1. James J. Feigenbaum & Christopher Muller & Elizabeth Wrigley-Field, 2019. "Regional and Racial Inequality in Infectious Disease Mortality in U.S. Cities, 1900–1948," Demography, Springer;Population Association of America (PAA), vol. 56(4), pages 1371-1388, August.
    2. Norman Bannenberg & Oddvar Førland & Tor Iversen & Martin Karlsson & Henning Øien, 2019. "Preventive Home Visits," CINCH Working Paper Series 1907, Universitaet Duisburg-Essen, Competent in Competition and Health.
    3. Anderson, D. Mark & Charles, Kerwin Kofi & Rees, Daniel I., 2019. "Public Health Efforts and the Decline in Urban Mortality: Reply to Cutler and Miller," IZA Discussion Papers 12077, Institute of Labor Economics (IZA).

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J1 - Labor and Demographic Economics - - Demographic Economics
    • N3 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy
    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development

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