Abstract (en): We examine the impact of the expansion of public prescription-drug insurance coverage from Medicare Part D and find evidence of substantial crowd-out. Using the 2002-2007 waves of the Medical Expenditure Panel Survey, we estimate the extension of Part D benefits resulted in 75 percent crowd-out of both prescription-drug insurance coverage and expenditures of those 65 and older. Part D is associated with sizeable reductions in out-of-pocket spending, much of which has accrued to a small proportion of the elderly. On average, we estimate a welfare gain from Part D comparable to the deadweight cost of program financing. (JEL H51, I18, J14)

Abstract (en): This data collection contains two data files derived from information gathered in the initial screening interview and Rounds 1-4 of the Household Survey component of the 1987 NATIONAL MEDICAL EXPENDITURE SURVEY (NMES). The Person File supplies data on each sampled person who reported coverage by Medicare at any time in 1987 and who responded to all rounds of the Household Survey for which he or she was eligible to respond. Data in this file include age, sex, race, marital status, education, employment status, personal and family income, coverage under private health insurance and public programs such as Medicaid and CAMPUS/CAMPVA, and the total number and cost of all prescriptions purchased in 1987 while under Medicare coverage. In addition, there are indicators of general health and specific medical conditions: stroke, cancer, heart disease, gallbladder disease, high blood pressure, hardening of the arteries, rheumatism, emphysema, arthritis and diabetes. The Prescribed Medicines Event File presents data pertaining to every instance a prescribed medicine was purchased or otherwise obtained by these Medicare beneficiaries during 1987. For respondents who were covered by Medicare for part of the year, only prescribed medicines acquired during the Medicare coverage period are included. This file gives the trade and generic name of each prescribed medication and reports the cost of the prescription and the medical condition for which it was prescribed. Civilian noninstitutionalized population of the United States living in housing units, group quarters, and other noninstitutional (nongroup) quarters. Stratified multistage area probability sample of dwelling units. Dwelling units including blacks, Hispanics, the elderly, the functionally impaired, and the poor were oversampled. 2006-03-30 File CB9340.SUPP.PDF was removed from any previous datasets and flagged as a study-level file, so that it will accompany all downloads.2006-03-30 All files were removed from dataset 3 and flagged as study-level files, so that they will accompany all downloads. (1) The principal investigator was formerly known as the National Center for Health Services Research and Health Care Technology Assessment. (2) The age distribution for Part 1: 17 and under (N=8), 18-63 (N=444), 64 (N=246), 65-74 (N=3,246), 75-84 (N=1,685), 85+ (N=409). (3) Parts 1 and 2 are linked by common identification variables. (4) Hard copy supplementary materials to the machine-readable documentation in Part 3 are supplied for this collection. (5) Part 2 contains alphabetic variables. (6) NMES consists of several surveys including two household panel surveys: the Household Survey and the Survey of American Indians and Alaska Natives (SAIAN). The Household Survey, from which this data collection is derived, surveyed the United States noninstitutionalized population and was fielded over four rounds of personal and telephone interviews at four-month intervals, with a short telephone interview constituting the fifth final round. SAIAN, which was conducted over three rounds of personal interviews, surveyed all persons who were eligible for care through the Indian Health Service and were living on or near reservations. These household surveys were supplemented by additional surveys, most important of which are the Health Insurance Plans Survey of employers and insurers of consenting household survey respondents, and the Medical Provider Survey of physicians, osteopaths, and inpatient and outpatient facilities, including home health care agencies reported as providing services to any member of the noninstitutionalized population sample. NMES also surveyed persons resident in or admitted to long-term care facilities (nursing homes and facilities for the mentally retarded) at any time in 1987. Information on these individuals was obtained from the Survey of Institutions, which collected data from facility administrators and designated staff, and the Survey of Next-of-Kin, which collected data from the respondent's next-of-kin or other knowledgeable persons. Together, the major components of NMES provide measures of health status and estimates of insurance coverage and the use of services, expenditures, and sources of payment for the period from January 1 to December 31, 1987 for the civilian population of the United States. NMES continues a series of national health care expenditure surveys carried out in the past, particularly the 1980 National Medical Care Utiliza...