How Does Health Insurance Impact Health? The Case of Medicare and Cancer Detection

48 Pages Posted: 30 Aug 2012

See all articles by Srikanth Kadiyala

Srikanth Kadiyala

RAND Corporation

Erin Strumpf

McGill University - Department of Economics; McGill University - Department of Epidemiology, Biostatistics, and Occupational Health

Date Written: August 1, 2012

Abstract

Does health insurance affect health and, if so, via what mechanisms? In this paper, we consider a relatively unexplored area in the economics literature, the effects of health insurance on health in the context of latent undiagnosed disease. Specifically, we use a regression discontinuity (RD) research design to examine the effect of Medicare coverage on cancer detection and find substantial increases: approximately 100 new cancers per 100,000 individuals are diagnosed at age 65. This is a 6.4% increase in cancer detection relative to the rate at age 64 and is nearly 116% larger than the trend in cancer detection that occurs in ages approaching 65. Approximately 65% of the increased detection is among breast, colorectal and prostate cancers, cancers for which there are well-established screening tests and 45% of these screening cancers are detected at stages that are likely amenable to treatment. The uninsured benefit differentially from cancer detection at age 65, due in part to their lower rates of cancer screening at younger ages compared to insured individuals. Results from this paper provide insights into the interactions between Medicare, the uninsured, U.S. cancer test utilization patterns and cancer epidemiology.

Keywords: health insurance, chronic disease, cancer, Medicare, regression discontinuity, cancer screening

JEL Classification: L1

Suggested Citation

Kadiyala, Srikanth and Strumpf, Erin, How Does Health Insurance Impact Health? The Case of Medicare and Cancer Detection (August 1, 2012). Available at SSRN: https://ssrn.com/abstract=2138454 or http://dx.doi.org/10.2139/ssrn.2138454

Srikanth Kadiyala

RAND Corporation ( email )

1776 Main Street
P.O. Box 2138
Santa Monica, CA 90407-2138
United States

Erin Strumpf (Contact Author)

McGill University - Department of Economics ( email )

855 Sherbrooke Street West
Montreal, QC H3A 2T7
CANADA

McGill University - Department of Epidemiology, Biostatistics, and Occupational Health ( email )

Montreal
United States

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