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The incidence of Medicare
Institution:1. Center for Surgery and Public Health, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA;2. Division of Urologic Surgery, Brigham and Women''s Hospital, Boston, MA, USA;3. Department of Medicine, Gastroenterology, Brigham and Women''s Hospital, Boston, MA, USA;4. Department of Surgery, Gastrointestinal and General Surgery, Brigham and Women''s Hospital, Boston, MA, USA;5. Department of Medical Oncology, Dana-Farber Cancer Institute, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA;6. Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA
Abstract:The Medicare program transfers nearly $300 billion annually from taxpayers to beneficiaries. This paper considers the incidence of such transfers in the context of a life cycle model with uncertainty about future health care expenditures. We find the distributional consequences of the Medicare program are roughly neutral in dollar terms; households living in high income neighborhoods pay more in taxes, but they also receive more in benefits. These dollar flows, however, ignore the insurance value of the Medicare system. Given the incomplete insurance coverage of lower income elderly households prior to the Medicare program, the money-metric benefits to lower income groups exceed the dollar flows, suggesting that Medicare redistributes more than a simple accounting exercise would suggest.
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