The distribution of public spending for health care in the United States, 2002

Health Affairs

Volumn 27, Issue 5, 2008, Pages

  Selden, Thomas M ^a   Sing, Merrile ^a  

^a AGENCY FOR HEALTHCARE RESEARCH AND QUALITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; CHILD; CONTROLLED STUDY; ETHNICITY; HEALTH CARE COST; HEALTH STATUS; HUMAN; MEDICAID; MEDICARE; POVERTY; UNITED STATES;

AGE FACTORS; AGED; CHILD; FINANCING, GOVERNMENT; HEALTH EXPENDITURES; HEALTH SERVICES ACCESSIBILITY; HUMANS; POVERTY; SEX FACTORS; TAXES; UNITED STATES;

EID: 54449093309     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.5.w349     Document Type: Article

References (41)

1. Centers for Medicare and Medicaid Services, "National Health Expenditure Projections, 2006-2016: Forecast Summary" (with selected tables), http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2006.pdf (accessed 7 July 2008).
2. J. Sheils and R. Haught, "The Cost of Tax-Exempt Health Benefits in 2004," Health Affairs 23 (2004):w106-w112 (published online 25 February 2004; 10.1377/hlthaff.w4.106);
3. and T.M. Selden and B.M. Gray, "Tax Subsidies for Employment-Related Health Insurance: Estimates for 2006," Health Affairs 25, no. 6 (2006):1568-1579.
4. Ibid.
5. World Bank, World Development Report 2004: Making Services Work for Poor People (Washington: World Bank and Oxford University Press, 2003) 37-40;
6. O. O'Donnell et al., "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," World Bank Economic Review 21, no. 1 (2007): 93-123;
7. and A. Wagstaff, E. van Doorslaer, F. Rutten, Equity in the Finance and Delivery of Health Care: An International Perspective (Oxford: Oxford University Press, 1993).
8. See also T.M. Selden and M.J. Wasylenko, "Benefit Incidence Analysis in Developing Countries," Policy Research Public Economics Working Paper no. WPS 1015 (Washington: World Bank, 1992).
9. W.L. Gillespie, "Effects of Public Expenditures on the Distribution of Income," in Essays in Fiscal Federalism, ed. R. Musgrave (Washington: Brookings Institution, 1965);
10. R.A. Musgrave, K.E. Case, and H. Leonard, "The Distribution of Fiscal Burdens and Benefits," Public Finance Quarterly 2, no. 3 (1974): 259-311;
11. M. Reynolds and E. Smolensky, Public Expenditures, Taxes, and the Distribution of Income: The U.S., 1950, 1961, 1970 (New York: Academic Press, 1977);
12. and P. Ruggles and M. O'Higgins, "The Distribution of Public Expenditure among Households in the United States," Review of Income and Wealth 27, no. 2 (1981): 137-164.
13. On Medicaid, see Kaiser Commission on Medicaid and the Uninsured, "Medicaid Facts: The Medicaid Program at a Glance," March 2007, http://www.kff.org/medicaid/upload/7235-02.pdf (accessed 7 July 2008);
14. On Medicare, see Medicare Payment Advisory Commission, A Data Book: Healthcare Spending and the Medicare Program, June 2007, http://medpac.gov/documents/Jun07DataBook_Entire_report.pdf (accessed 19 September 2007);
15. Centers for Medicare and Medicaid Services, An Overview of the U.S. Health Care System, January 2007, http://www.cms.hhs.gov/TheChartSeries/ downloads/Chartbook_2007_pdf.pdf (accessed 17 July 2008);
16. M. McClellan and J. Skinner, "The Incidence of Medicare," Journal of Public Economics 90, no. 1-2 (2006): 257-276;
17. J. Bhattacharya and D. Lakdawalla, "Does Medicare Benefit the Poor?" Journal of Public Economics 90, no. 1-2 (2006): 277-292;
18. and J. Skinner and W. Zhou, "The Measurement and Evolution of Health Inequality: Evidence from the U.S. Medicare Population," NBER Working Paper no. 10842 (Cambridge, Mass.: National Bureau of Economic Research, 2004).
19. On tax subsidies, see Sheils and Haught, "The Cost of Tax-Exempt Health Benefits in 2004";
20. Selden and Gray, "Tax Subsidies for Employment-Related Health Insurance";
21. and T.M. Selden and D.M. Bernard, "Tax Incidence and Net Benefits in the Market for Employment-Related Health Insurance: Sensitivity of Estimates to the Incidence of Employer Costs," International Journal of Health Care Finance and Economics 4, no. 2 (2004): 167-192.
22. S.P. Keehan et al., "Age Estimates in the National Health Accounts," Health Care Financing Review Web Exclusive 1, no. 1 (2004): 1-16 (published online 2 December 2004; http://www.cms.hhs.gov/ HealthCareFinancingReview/Downloads/Keehan.pdf).
23. J.W. Cohen et al., "The Medical Expenditure Panel Survey: A National Health Information Resource," Inquiry 33, no. 4 (1996/1997): 373-389;
24. and S.B. Cohen, Sample Design of the 1996 Medical Expenditure Panel Survey Household Component, Methodology Report no. 2, July 1997, http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr2/mr2.pdf (accessed 17 July 2008).
25. M. Sing et al., "Reconciling Medical Expenditure Estimates from the MEPS and NHEA, 2002," Health Care Financing Review 28, no. 1 (2006): 25-40.
26. Agency for Healthcare Research and Quality, "Total Health Services - Mean and Median Expenses Person with Expense and Distribution of Expenses by Source of Payment: United States, 2004"; these data, in searchable format, are available on the AHRQWeb site, http://www.meps.ahrq.gov/mepsweb.
27. T.M. Selden and M. Sing, "Aligning the Medical Expenditure Panel Survey to Aggregate U.S. Benchmarks," MEPS Working Paper no. 8006, http://www.meps.ahrq.gov/mepsweb/data_files/publications/workingpapers/wp_08006. pdf (accessed 22 July 2008).
28. CMS, "National Health Expenditure Accounts: Overview," 2007, at http://www.cms.hhs.gov/National Health Expend Data (accessed 20 September 2007).
29. Sing et al., "Reconciling Medical Expenditure Estimates."
30. Selden and Sing, "Aligning the Medical Expenditure Panel Survey," presents details from an updated reconciliation that widens the NHEA-MEPS gap from 13.8 percent to 14.4 percent.
31. Selden and Sing, "Aligning the Medical Expenditure Panel Survey."
32. For an example of research that counts public employees' health insurance benefits as tax-financed public health insurance programs, see S. Woolhandler and D.U. Himmelstein, "Paying for National Health Insurance - and Not Getting It," Health Affairs 21, no. 4 (2002): 88-98.
33. D. Feenberg and E. Coutts, "An Introduction to the TAXSIM Model," Journal of Policy Analysis and Management 12, no. 1 (1993): 189-194.
34. TAXSIM version 6.2was used. See NBER, "TAXSIM Related Files at the NBER," http://www.nber.org/~taxsim (accessed 20 September 2007).
35. F.A. Sloan, H.H. Zhang, and J. Wang, "Upstream Intergenerational Transfers," Southern Economic Journal 69, no. 2 (2002): 363-380.
36. B. Wolfe and R. Moffitt, "A New Index to Value In-Kind Benefits," Review of Income and Wealth 37, no. 4 (1991): 387-408.
37. Skinner and Zhou, "The Measurement and Evolution of Health Inequality."
38. McClellan and Skinner, "The Incidence of Medicare";
39. and Bhattacharya and Lakdawalla, "Does Medicare Benefit the Poor?"
40. Early estimates of Medicare Part D spending on prescription drugs can be found in W. Yin et al., "The Effect of the Medicare Part D Prescription Drug Benefit on Drug Utilization and Expenditures," Annals of Internal Medicine 148, no. 3 (2008): 169-177. We are not aware of any research examining the effect of Medicare Part Don non-prescription drug spending.
41. Authors' calculations based on unpublished estimates used for the NHEA-MEPS reconciliation in Sing et al., "Reconciling Medical Expenditure Estimates." Similar results for the public share can be derived from Tables 4.1-4.4 in CMS, Health and Health Care of the Medicare Population: Data from the 2002 Medicare Beneficiary Survey, http://www.cms.hhs.gov/mcbs/ downloads/HHC2002section4.pdf (accessed 7 July 2008).