For decades, Americans have squabbled over whether the government should expand Medicare, maintain its current scope, or cut it altogether. But their debates have suffered for lack of an answer to one vital question: Does Medicare make a difference?
A new study shows that Medicare indeed makes a difference for seriously ill patients—and that difference is the one between life and death. Following the fates of more than 400,000 people admitted to California hospitals through their emergency departments, a team of economists finds that patients who are just over 65 years old—and thus eligible for Medicare—are 20 percent less likely to die within a week of admission than are their slightly younger counterparts who do not yet qualify for the government insurance.
“Until this paper, no one thought that health insurance of any kind affected something as straightforward as death rates,” says David Card, a professor of economics at the University of California, Berkeley, and the study’s lead author. “Fact is, if you show up at the hospital without insurance, they’ll take you in and give you fairly decent treatment.”
But the Medicare-eligible set seems to get somewhat better treatment, Card and his colleagues find. Their study reveals that patients between 65 and 70 have more procedures and higher bills than do patients between 60 and 64, hinting that Medicare-aged patients are receiving more care. This closer attention may give Medicare recipients an edge on surviving their trip to the ER, Card says.
Card’s study also suggests that Medicare recipients fare better than not only the uninsured, but also the privately insured. “A lot of people do not have very good insurance,” he explains. In addition, hospital staff must sometimes waste valuable time untangling what exactly a particular insurance company will cover for a particular patient before delivering aid. “But hospitals don’t have to call up to find out what Medicare can do,” he notes.
For their study, Card and his coauthors took advantage of the fact that some 80 percent of Americans enroll in Medicare within a few days of their 65th birthdays. As a result, the researchers could apply a sophisticated statistical test that compares the outcomes of people on either side of the Medicare-age line—that is, people ages 60 to 64 vs. people ages 65 to 70.
To make sure that these two groups were equally sick, the researchers restricted their study to people who reported to hospital emergency departments with strokes, heart attacks, respiratory failure, and other life-threatening illnesses. “These events bring people to the ER regardless of their insurance coverage,” Card says. The team then examined which of these very sick people survived a day, a week, a month, and other time intervals up to two years. Their findings demonstrate that even nine months later, 20 percent more Medicareaged patients than younger patients were still alive.
Read more stories by Alana Conner.