The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare

73 Pages Posted: 25 Mar 2004 Last revised: 29 Apr 2022

See all articles by David Card

David Card

University of California, Berkeley - Department of Economics; Institute for the Study of Labor (IZA); National Bureau of Economic Research (NBER)

Carlos Dobkin

University of California, Santa Cruz - Department of Economics

Nicole Maestas

Harvard Medical School - Department of Health Care Policy

Date Written: March 2004

Abstract

We use the increases in health insurance coverage at age 65 generated by the rules of the Medicare program to evaluate the effects of health insurance coverage on health related behaviors and outcomes. The rise in overall coverage at age 65 is accompanied by a narrowing of disparities across race and education groups. Groups with bigger increases in coverage at 65 experience bigger reductions in the probability of delaying or not receiving medical care, and bigger increases in the probability of routine doctor visits. Hospital discharge records also show large increases in admission rates at age 65, especially for elective procedures like bypass surgery and joint replacement. The rises in hospitalization are bigger for whites than blacks, and for residents of areas with higher rates of insurance coverage prior to age 65, suggesting that the gains arise because of the relative generosity of Medicare, rather than the availability of insurance coverage. Finally, there are small impacts of reaching age 65 on self-reported health, with the largest gains among the groups that experience the largest gains in insurance coverage. In contrast we find no evidence of a shift in the rate of growth of mortality rates at age 65.

Suggested Citation

Card, David E. and Dobkin, Carlos and Maestas, Nicole, The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare (March 2004). NBER Working Paper No. w10365, Available at SSRN: https://ssrn.com/abstract=516706

David E. Card (Contact Author)

University of California, Berkeley - Department of Economics ( email )

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Institute for the Study of Labor (IZA)

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National Bureau of Economic Research (NBER)

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Carlos Dobkin

University of California, Santa Cruz - Department of Economics ( email )

Santa Cruz, CA 95064
United States

Nicole Maestas

Harvard Medical School - Department of Health Care Policy ( email )

180 Longwood Avenue
Boston, MA 02115
United States

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