Paul D. Jacobs (
Health Aff (Millwood). 2021 Feb;40(2):266-273. doi: 10.1377/hlthaff.2020.00940.
Medicare pays for roughly one in four physician visits in the United States, yet a rigorous understanding of how Medicare currently affects access to and affordability of care for its enrollees is unavailable. Using data from the Medical Expenditure Panel Survey-Household Component and the National Health Interview Survey, I tested for changes in access to care and affordability around age sixty-five, when most people gain eligibility for Medicare. I found that Medicare eligibility is associated with a 1.5-percentage-point reduction in reports of being unable to get necessary care (a 50.9 percent reduction compared with the percentage at age sixty-four) and a 4.1-percentage-point (45.3 percent) reduction in not being able to get needed care because of the cost. Recently, policy makers have proposed various ways of extending Medicare coverage. These results suggest that incremental Medicare expansions could have positive access and affordability benefits for enrollees compared with the insurance options available to them before they turn sixty-five.
医疗保险为美国大约四分之一的医生就诊提供了支付，然而，对于医疗保险目前如何影响其参保者获得和负担得起医疗保健的情况，人们还没有一个严格的了解。我使用来自医疗支出调查-家庭部分和国家健康访谈调查的数据，测试了在大多数人获得医疗保险资格的六十五岁左右，获得医疗保健的机会和负担能力的变化。我发现，医疗保险资格与报告无法获得必要医疗的人数减少了 1.5 个百分点（与六十四岁时的百分比相比，减少了 50.9%），以及因为费用而无法获得所需医疗的人数减少了 4.1 个百分点（45.3%）。最近，政策制定者提出了各种扩大医疗保险范围的方法。这些结果表明，与参保者在六十五岁之前可获得的保险选择相比，增加医疗保险覆盖范围可能会对参保者的获得和负担能力产生积极影响。
