We explored whether cancer detection and mortality rates shifted at age 65, when Americans become eligible for Medicare in a study that was published in the Journal of Policy Analysis and Management. The results of the study were featured in a recently released podcast hosted by the journal—JPAM’s Closer Look.
Medicare is one of the largest insurance programs in the United States and provides for near universal access at the eligibility age of 65. The study examined data from the National Cancer Institute’s Surveillance, Epidemiology and End Results program on patients aged 59-71 to analyze what happens when near universal coverage is available.
The researchers focused on breast, colorectal and lung cancer because guidelines recommend screenings for those conditions before — as well as after — age 65. They operated under the hypothesis that, in the absence of Medicare, outcomes would remain steady throughout the age group analyzed.
The findings show access to Medicare coverage increases cancer detection and reduces cancer mortality. Cancer detection increased by 10% at age 65 compared to people just one or two years younger.
In terms of survival, the analysis revealed a 4.5% decrease in cancer mortality for women age 65 when contrasted with women age 63-64. The results were even better for black women, who saw cancer mortality drop by 9% compared to their slightly younger peers.
To ensure the validity of their findings, the investigators also examined cancer detection and mortality rates in Canada, a country with similar demographics to the U.S. but that offers universal care throughout the lifespan. The statistics showed cancer fatality rates before age 65 to be nearly equal between the nations. However, after age 65 rates declined among Americans but remained steady for Canadians — suggesting that Medicare accounts for the difference.
If heeded by policymakers, the study’s findings have important ramifications for the future of Medicare and the need for widely available healthcare insurance.
Full study here. An earlier version of this study was published as an NBER working paper. A press release about this study is available here.
Citation: Myerson, R. M., Tucker‐Seeley, R. D., Goldman, D. P., & Lakdawalla, D. N. (2020). Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?. Journal of Policy Analysis and Management.