Socio-economic Disparities in U.S. Healthcare Spending: The Role of Public vs. Private Insurance

Elena Capatina, Michael Keane () and Shiko Maruyama

No 2018-03, Discussion Papers from School of Economics, The University of New South Wales

Abstract: In the US healthcare system, patients of different socio-economic status (SES) often receive disparate treatment for similar conditions. Prior work documents this phenomenon for particular treatments/conditions, but we take a system-wide view and examine socioeconomic disparities in spending for all medical conditions at the 3-digit ICD-9 level. We also compare SES spending gradients for those covered by private vs. public insurance (Medicare). Using data on adult respondents from the Medical Expenditure Panel Survey 2000-14, we estimate multivariate regressions for individual medical spending (total and out-of-pocket) controlling for medical conditions, demographics, health, and insurance, separately by sex, education, and age. Within age-sex categories, we assess how spending on each condition varies with education (a proxy for SES). In the predominantly privately insured population aged 24-64, system spending for several of the most socially costly conditions is strongly increasing in education (e.g., breast cancer for women and chest symptoms for men). These disparities are not explained by differences in health, insurance status, or ability-to-pay, suggesting they arise due to discrimination. However, we find no positive SES gradients for individuals over 64 covered by the public Medicare program, suggesting that Medicare plays an important role in improving equity.

Keywords: Education gradient; Health insurance systems; Healthcare equity; Private and Public health insurance; Socio-economic disparities (search for similar items in EconPapers)
JEL-codes: I13 I14 I18 (search for similar items in EconPapers)
Pages: 34 pages
Date: 2018-02
New Economics Papers: this item is included in nep-edu, nep-hea and nep-ias
References: Add references at CitEc
Citations:

Downloads: (external link)
http://research.economics.unsw.edu.au/RePEc/papers/2018-03.pdf (application/pdf)
Our link check indicates that this URL is bad, the error code is: 503 Service Unavailable: Back-end server is at capacity

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:swe:wpaper:2018-03

Access Statistics for this paper

More papers in Discussion Papers from School of Economics, The University of New South Wales Contact information at EDIRC.
Bibliographic data for series maintained by Hongyi Li ().