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Quarterly Journal of Economics

Quarterly (February, May, August, November)
400 pp. per issue, 6 x 9
Founded: 1886
ISSN 0033-5533
E-ISSN 1531-4650
2008 ISI Impact Factor: 5.048


Quarterly Journal of Economics

May 2009, Vol. 124, No. 2, Pages 597-636
Posted Online May 19, 2009.
(doi:10.1162/qjec.2009.124.2.597)
© 2009 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology.
Does Medicare Save Lives?*

David Card

University of California, Berkeley.

Carlos Dobkin

University of California, Santa Cruz.

Nicole Maestas

RAND Corporation.

PDF (291.633 KB) PDF Plus (292.46 KB)

Health insurance characteristics shift at age 65 as most people become eligible for Medicare. We measure the impacts of these changes on patients who are admitted to hospitals through emergency departments for conditions with similar admission rates on weekdays and weekends. The age profiles of admissions and comorbidities for these patients are smooth at age 65, suggesting that the severity of illness is similar on either side of the Medicare threshold. In contrast, the number of procedures performed in hospitals and total list charges exhibit small but statistically significant discontinuities, implying that patients over 65 receive more services. We estimate a nearly 1-percentage-point drop in 7-day mortality for patients at age 65, equivalent to a 20% reduction in deaths for this severely ill patient group. The mortality gap persists for at least 9 months after admission.

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