Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?

Rebecca Mary Myerson, Reginald Tucker-Seeley, Dana Goldman, Darius N. Lakdawalla

NBER Working Paper No. 26292
Issued in September 2019, Revised in November 2019
NBER Program(s):Economics of Aging, Health Care, Health Economics

Medicare is a large government health insurance program in the United States which covers about 60 million people. 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 for which screening is recommended both 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.

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Document Object Identifier (DOI): 10.3386/w26292

Published: Rebecca M. Myerson, Reginald D. Tucker‐Seeley, Dana P. Goldman, and Darius N. Lakdawalla “Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?” Journal of Policy Analysis and Management citation courtesy of

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