Health insurance reform: The impact of a Medicare buy-in |
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| Institution: | 1. University of California (UCLA), Los Angeles, United States;2. National Graduate Institute for Policy Studies (GRIPS), Tokyo, Japan;3. Sungkyunkwan University (SKKU), Seoul, Republic of Korea;1. Center for Reducing Health Disparities, The MetroHealth System, Cleveland, Ohio;2. Prevention Research Center for Healthy Neighborhoods, Cleveland, Ohio;3. Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio;4. Division of Nephrology and Hypertension, Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio;5. Division of Nephrology, Department of Medicine, The MetroHealth System, Cleveland, Ohio;7. Center for Clinical Informatics Research and Education and Department of Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, Ohio;11. Centers for Dialysis Care, Cleveland, Ohio;12. Department of Bioethics, Case Western Reserve University, Cleveland, Ohio;1. Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA;2. Center for Healthcare Value, University of California, San Francisco, San Francisco, California, USA;3. Department of Medicine, University of California, San Francisco, San Francisco, California, USA;4. Department of Medicine, Dell Medical School at the University of Texas at Austin, Austin, Texas, USA;5. Continuous Process Improvement Department, UCSF Health, San Francisco, California, USA |
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| Abstract: | The steady-state general equilibrium and welfare consequences of a Medicare buy-in program, optional for those aged 55–64, is evaluated in a calibrated life-cycle economy with incomplete markets. Incomplete markets and adverse selection create a potential welfare improving role for health insurance reform. We find that adverse selection eliminates any market for a Medicare buy-in if it is offered as an unsubsidized option to individual private health insurance. The subsidy needed to bring the number of uninsured to less than 5 percent of the target population could be financed by an increase in the labor income tax rate of just 0.03–0.18 percent depending on how the program is implemented. |
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| Keywords: | Health insurance Life cycle model Incomplete markets |
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