Search Results
Journal Article
States may face higher spending in give-and-take of Medicare/Medicaid changes
Despite a markedly improved outlook for state finances, New Englands states still face significant fiscal pressures moving forward into the current and next fiscal years. Prominent among these challenges are two changes to the Medicaid and Medicare programs that could significantly increase state health care costs.
Working Paper
Demographics and medical care spending: standard and non-standard effects
In this paper, we examine the effects of likely demographic changes on medical spending for the elderly. Standard forecasts highlight the potential for greater life expectancy to increase costs: medical costs generally increase with age, and greater life expectancy means that more of the elderly will be in the older age groups. Two factors work in the other direction, however. First, increases in life expectancy mean that a smaller share of the elderly will be in the last year of life, when medical costs generally are very high. Furthermore, more of the elderly will be dying at older ages, ...
Working Paper
Should America save for its old age? Population aging, national saving, and fiscal policy
While popular wisdom holds that the United States should save more now in anticipation of the aging of the baby boom generation, the optimal response to population aging from a macroeconomic perspective is not clear-cut. Indeed, Cutler, Poterba, Sheiner, and Summers ("CPSS",1990) argued that the optimal response to the coming demographic transition was more likely to be a reduction in national saving than an increase. In this paper we reexamine this question. In particular, we ask how the optimal saving response depends on the openness of our economy, on how we view the consumption of ...
Working Paper
Social security and Medicare policy from the perspective of generational accounting
An application of the generational accounting method of fiscal policy analysis to projected spending paths for Social Security and Medicare suggesting that, under realistic assumptions for these programs, future generations as well as current young Americans could bear a significantly larger share of the burden of government spending than previously thought.
Report
An Aggregate Model for Policy Analysis with Demographic Change
Many countries are facing challenging fiscal financing issues as their populations age and the number of workers per retiree falls. Policymakers need transparent and robust analyses of alternative policies to deal with demographic changes. In this paper, we propose a simple framework that can easily be matched to aggregate data from the national accounts. We demonstrate the usefulness of our framework by comparing quantitative results for our aggregate model with those of a related model that includes within-age-cohort heterogeneity through productivity differences. When we assess proposals ...
Journal Article
Social Security and Medicare : the impending fiscal challenge
Social Security?and the solvency of its Trust Fund?have increasingly become a focus of discussion in the media and policy circles. The basic problem is that promised benefits will soon exceed program revenues. Without changes in benefits or funding, the Trustees of Social Security project that assets in the Trust Fund will be depleted in 2041. While Social Security is a serious problem for taxpayers and beneficiaries, Medicare poses an even greater challenge. Together, the two programs? benefits currently amount to about 6 percent of GDP. By 2080 they are projected to swell to 20 percent. ...
Journal Article
Medicare: usual and customary remedies will no longer work
A description of the structural deficiencies that have led to Medicare's impending bankruptcy, and a discussion of the merits of alternative approaches to extending the program's long-term viability. The author argues that the best approach is to adopt a "defined contribution" plan that will restore consumers' interest in economizing on health care services and boost competition among providers and insurers.
Working Paper
The value of Medicare managed care plans and their prescription drug benefits
I estimate the welfare, both gross and net, provided by the Medicare managed care program in 1999 through 2002. First, I estimate a model of demand for the benefits offered by managed care plans to Medicare beneficiaries. I then use the demand estimates to form estimates of welfare provided by the program. Medicare beneficiaries derived $14.9 billion of gross welfare per year from the Medicare HMO program. Depending on the amount of selection in the program, the Medicare managed care program provided from -$10.3 billion to $35.1 billion of net welfare total over the four-year period. I also ...
Journal Article
Enhancing future retirement income through 401(k)s
With too many retirees and too few funds expected, the future of the country's social security and medicare programs is likely to be in peril. Can 401(k)s save the day?
Working Paper
The geography of Medicare
There is a great deal of geographic variation in Medicare spending. For example, while the average Medicare cost per beneficiary was around $5200 in 1996, Medicare spending, adjusted for differences in regional prices and demographic composition, was about $8000 per person in Miami, but only $3500 in Minneapolis. In this paper, we explore the source of this variation. We find that a substantial amount can be explained by differences across areas in the health of the elderly population. This finding suggests that some of the geographic variation in Medicare spending is efficient. But even ...