The impact of universal medicare on the previously insured poor and nonpoor : Medicare impact study

The question of the "targetted" plan's effectiveness in raising utilization by the "targetted" poor could not be examined in its own right; such a study would compare the medical care utilization of the "targetted" population in the presence and in the absence of the "targetted" plan, and data to conduct such a comparison were unavailable. [...] Within the combined cohorts, it increased in 8 of the age-sex cells (reductions were observed only in the 1-13 age-group and undoubtedly reflect the aging of the cohorts, with the youngest members moving along the steeply declining portion of the life-cycle age-utilization profile). [...] However, the evidence of relative change in poor/nonpoor utilization rates between the first and fourth Medicare years is that there was no statistically significant difference in the rate of increase in the rate of utilization of the poor cohort relative to the nonpoor cohort. [...] Expenditure per regular utilizer, on the other hand, was estimated to be greater in the poor cohort than in the nonpoor cohort throughout the period studied: 7% greater in the pre-Medicare year, 20% greater in the first Medicare year, and 26% greater in the fourth Medicare year. [...] While the price elasticity of demand (the proportional change in quantity demanded over the proportional change in price) estimated for the poor cohort exceeded that estimated for the nonpoor cohort, the estimated impact of billings above tariff, measured in terms of the absolute or the percentage reduction in utilization of physicians services, was less for the poor because the level of billings