TY  - JOUR
AU  - Feenberg,Daniel
AU  - Skinner,Jonathan
TI  - The Risk and Duration of Catastrophic Health Care Expenditures
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 4147
PY  - 1992
Y2  - August 1992
UR  - http://www.nber.org/papers/w4147
L1  - http://www.nber.org/papers/w4147.pdf
N1  - Author contact info:
Daniel R. Feenberg
National Bureau of Economic Research
1050 Massachusetts Avenue
Cambridge, MA 02138
Tel: 617/588-0343
Fax: 617/868-2742
E-Mail: feenberg@nber.org

Jonathan S. Skinner
Department of Economics
6106 Rockefeller Hall
Dartmouth College
Hanover, NH 03755
Tel: 603/646-2535
Fax: 603/646-2122
E-Mail: jonathan.skinner@dartmouth.edu
M2  - featured in NBER digest on 1992-12-01
AB  - Catastrophic medical expenses are an important economic risk facing the elderly. Little is known about the persistence of such out-of-pocket medical costs. We measure the time-series property of medical costs using information on medical deductions from a panel of tax returns. During the period of analysis, 1968-73, taxpayers could deduct medical expenses above 3 percent of income. We correct for the resulting censoring bias using multivariate Tobit estimated with a variant of the smoothed simulated maximum likelihood (SSML) method. The data suggest that the burden of out-of-pocket medical expenses is substantially larger for lower income families. Furthermore, the estimated coefficients suggest substantial time-persistence in out-of-pocket medical care costs; a $1 increase in out-of-pocket medical spending is predicted to increase future spending by an additional $2.80. These results may shed light both on the social value of catastrophic health insurance as well on aggregate saving behavior.
ER  -