Search Results
Journal Article
Medicaid and the elderly
In 2009, Medicaid spent over $75 billion on 5.3 million elderly beneficiaries. This article describes the Medicaid rules for the elderly and discusses their economic implications.
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
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 ...
Working Paper
Advertising and Risk Selection in Health Insurance Markets
We study impacts of advertising as a channel of risk selection in Medicare Advantage. We show evidence that both mass and direct mail advertising are targeted to achieve risk selection. We develop and estimate an equilibrium model of Medicare Advantage with advertising to understand its equilibrium impacts. We find that advertising attracts the healthy more than the unhealthy. Moreover, shutting down advertising increases premiums by up to 40% for insurers that advertised by worsening their risk pools, which further reduces the demand of the unhealthy. We argue that risk selection may make ...
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, ...
Journal Article
Speaking of accounting scandals...
The better stockholders' information about a firm's prospective finances, the better their decisions on investing their money productively. The same is true of lawmakers' decisions on how to allocate public funds. As the Enron-Andersen debacle has made abundantly clear, murky financial reporting can have devastating consequences. Is something similar happening with reporting on government finances-especially with regard to Social Security and Medicare?
Newsletter
The Recent Rise in Health Care Inflation
Health care services inflation was consistently at or above 3% per year in the early 2000s, declined from around 3% at the end of the 2000s to under 1% in 2015, and then rebounded to just under 2% in early 2018. The low point in 2015 was a near-historical low, with health care services price growth bottoming out at a rate not seen since 1961.
Working Paper
Flexible Retirement and Optimal Taxation
Raising the retirement age is a common policy response when social security schemes face fiscal pressures. We develop and estimate a dynamic life cycle model to study optimal retirement and tax policy when individuals face health shocks and income risk and make endogenous retirement decisions. The model incorporates key features of Social Security, Medicare, income taxation, and savings incentives and distinguishes three channels through which health affects retirement: nonconvexities in labor supply due to health-dependent fixed costs of working, earnings reductions, and mortality risk. We ...