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Does Medicare benefit the poor?
Affiliation:1. Harvard University, United States;2. NBER, United States;1. University of Paderborn, Germany;2. University of Paderborn, RWI & CINCH, Germany;1. RAND Corporation, Santa Monica, CA, United States;2. Group Health Research Institute, Seattle,` WA, United States;3. Marshfield Clinic Research Foundation, Epidemiology Research Center, Marshfield, WI, United States;4. Geisinger Center for Health Research, Danville, PA, United States;5. Henry Ford Health System, Department of Pathology, Detroit, MI, United States;6. Kaiser Permanente, Center for Health Research Northwest, Portland, OR, United States;7. Minnesota Department of Health, Minnesota Cancer Surveillance System, Saint Paul, MN, United States;8. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States;1. Institute of Gerontology & Department of Economics, Wayne State University, 87 E. Ferry St., Detroit, MI 48202, United States;2. Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States;3. Center for Health Policy and Health Services Research, Henry Ford Health System, One Ford Place, Detroit, MI 48202, United States;4. Institute of Gerontology, Wayne State University, 87 E. Ferry St., Detroit, MI 48202, United States
Abstract:Measuring the progressivity of age-targeted government programs is difficult because no single data set measures income and benefit use throughout life. Previous research, using zip code as a proxy for lifetime income, has found that Medicare benefits flow primarily to the most economically advantaged groups, and that the financial returns to Medicare are often higher for the rich than the poor. However, our analysis produces the starkly opposed result that Medicare is an extraordinarily progressive public program, in dollar terms or welfare terms. These new results owe themselves to our measurement of socioeconomic status as an individual's education, rather than the geographically aggregated measures of income used by previous research. We argue that individual education has important practical and conceptual advantages over geographically aggregated measures of income. Our results suggest the crucial importance of accurate poverty measurement in evaluating the progressivity of complex government programs like Medicare or Social Security.
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