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Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?
Author(s) -
Myerson Rebecca M.,
TuckerSeeley Reginald D.,
Goldman Dana P.,
Lakdawalla Darius N.
Publication year - 2020
Publication title -
journal of policy analysis and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.898
H-Index - 84
eISSN - 1520-6688
pISSN - 0276-8739
DOI - 10.1002/pam.22199
Subject(s) - medicine , population , health care , cancer , demography , breast cancer , lung cancer , gerontology , medicaid , logistic regression , environmental health , oncology , sociology , economics , economic growth
Medicare is a large government health insurance program in the United States that 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 nine 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.