Wednesday, October 9, 2019

Medicare for All

The abstract for "Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?" by Rebecca Mary Myerson, Reginald Tucker-Seeley, Dana Goldman and Darius N. Lakdawalla:
Medicare is the largest government insurance program in the United States, providing coverage for over 60 million people in 2018. This paper analyzes the effects of Medicare insurance on health for a group of people in urgent need of medical care – people with cancer. We used a regression discontinuity design to assess impacts of near-universal Medicare insurance at age 65 on cancer detection and outcomes, using population-based cancer registries and vital statistics data. Our analysis focused on the three tumor sites with recommended screening before and after age 65: breast, colorectal, and lung cancer. At age 65, cancer detection increased by 72 per 100,000 population among women and 33 per 100,000 population among men; cancer mortality also decreased by 9 per 100,000 population for women but did not significantly change for men. In a placebo check, we found no comparable changes at age 65 in Canada. This study provides the first evidence to our knowledge that near-universal access to Medicare at age 65 is associated with improvements in population-level cancer mortality, and provides new evidence on the differences in the impact of health insurance by gender.
I can't vouch for the results, not having read the article in full, but the study design looks good, provided they avoided the spurious results from higher order nonlinear relationships separated by the discontinuity.

2 comments: said...

I am wondering if there would have been more of a male effect if prostate cancer had also been considered. Lung cancer is the most common cancer in both genders, but breast is second for women while prostate is second for men. Colorectal is third for each gender, but is second overall.

As it is, apparently the US is the best nation to get colorectal cancer, although Japan and France are nearly as good. At the other end, the US is way down the lists for heart disease.

jamzo said...

what is the purpose of the endless debate as to whether being able to pay for health care is beneficial and worthwhile ... there are some things that are obvious ... part of the debate is a result of the financing of the academic research establishment ... part of the debate is resistance to the idea that enjoying the benefit of societal healthcare knowledge and skills is a right ... part of the debate is ignoring the continuing governmental subsidy of wall street investors, private health insurers and bio-pharmaceutical companies