Does health insurance improve health outcomes?
There is a large literature on this topic including fairly recent work from the Oregon Health Insurance Experiment (see Finkelstein et al. (QJE 2012), Baicker et al. AER 2014, Finkelstein et al. JPE 2019). Many of these studies look at the population level; as the majority of people are healthy, the incremental benefit for health insurance may be more modest compared to its value when individuals have more severe diseases.
To test this proposition, a paper by Myerson et al. 2019 examines how eligibility for Medicare affected the ability to detect and effectively treat patients with cancer. Using a regression discontinuity design comparing cancer screening and outcomes in the US (<65 vs. ≥65 years) compared to Canada where there is universal coverage across all ages. The authors use data from 2001-2015 and find:
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 nine 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.
In short, it appears that insurance–at last in the case of cancer–does improve cancer screening and reduce mortality, at least for females.
- Myerson, Rebecca M., Reginald D. Tucker‐Seeley, Dana P. Goldman, and Darius N. Lakdawalla. “Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?.” Journal of Policy Analysis and Management (2019).
Discover Past Posts