Waiting for Medicare

From Affording to Wait: Medicare Initiation and the Use of Health Care, by Guy David, Phil Saynisch, Victoria Acevedo-Perez, and Mark Neuman:

Our examination of data from Florida and North Carolina finds an abrupt increase in utilization of colonoscopy and lens and cataract procedures at age 65 years, not observed for any other age threshold between 50 and 75 years. We find this increase to be attributable almost entirely to the initiation of Medicare benefits at this age. Not surprisingly, a comparable discontinuity does not occur for procedures that are not typically covered by Medicare, such as elective cosmetic surgery, or are required for treatment of a set of life‐threatening emergencies or a set of acutely painful conditions. […]

Our findings have important policy implications. These findings support an argument that uninsurance or underinsurance among adults younger than 65 years may result in potentially harmful delays in receipt of necessary diagnostic and therapeutic procedures. However, our work further argues that taxpayer‐funded insurance programs may effectively finance procedures that could have been performed at a younger age but instead have been delayed until after age 65 years. We urge further research to evaluate the potential costs of such delays in care on both individual health outcomes and the costs borne by taxpayer‐funded health care in the USA.

See also the work of Michael McWilliams and colleagues.

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