Working Paper: NBER ID: w26292
Authors: Rebecca Mary Myerson; Reginald Tucker-Seeley; Dana Goldman; Darius N. Lakdawalla
Abstract: Medicare is a large government health insurance program in the United States which covers about 60 million people. This paper analyzes the effects of Medicare insurance on health for a group of people in urgent need of medical care: people with cancer. We used a regression discontinuity design to assess impacts of near-universal Medicare insurance at age 65 on cancer detection and outcomes, using population-based cancer registries and vital statistics data. Our analysis focused on the three tumor sites for which screening is recommended both before and after age 65: breast, colorectal, and lung cancer. At age 65, cancer detection increased by 72 per 100,000 population among women and 33 per 100,000 population among men; cancer mortality also decreased by 9 per 100,000 population for women but did not significantly change for men. In a placebo check, we found no comparable changes at age 65 in Canada. This study provides the first evidence to our knowledge that near-universal access to Medicare at age 65 is associated with improvements in population-level cancer mortality and provides new evidence on the differences in the impact of health insurance by gender.
Keywords: Medicare; Cancer Detection; Mortality Outcomes
JEL Codes: I13; I18; I28
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Medicare coverage (I13) | cancer detection rates (J78) |
| Medicare coverage (I13) | cancer mortality (I12) |
| age 65 (J14) | Medicare coverage (I13) |
| cancer detection rates (J78) | cancer mortality (I12) |