[go: up one dir, main page]

IDEAS home Printed from https://ideas.repec.org/p/diw/diwwpp/dp1226.html
   My bibliography  Save this paper

Health Care Expenditures and Longevity: Is There a Eubie Blake Effect?

Author

Listed:
  • Friedrich Breyer
  • Normann Lorenz
  • Thomas Niebel
Abstract
It is still an open question whether increasing life expectancy as such is causing higher health care expenditures (HCE) in a population. According to the "red herring" hypothesis, the positive correlation between age and HCE is exclusively due to the fact that mortality rises with age and a large share of HCE is caused by proximity to death. As a consequence, rising longevity - through falling mortality rates - may even reduce HCE. However, a weakness of previous empirical studies is that they use cross-sectional evidence to make inferences on a development over time. In this paper we analyse the impact of rising longevity on the trend of HCE over time by using data for a pseudo-panel of German sickness fund members over the period 1997-2009. Using (dynamic) panel data models, we find that age, mortality and five-year survival rates have a positive impact on per-capita HCE. Our explanation for the last finding is that physicians treat patients more aggressively if they think the result will pay off for a longer time span, which we call "Eubie Blake effect". A simulation on the basis of an official population forecast for Germany is used to isolate the effect of demographic ageing on real per-capita HCE over the next decades.

Suggested Citation

  • Friedrich Breyer & Normann Lorenz & Thomas Niebel, 2012. "Health Care Expenditures and Longevity: Is There a Eubie Blake Effect?," Discussion Papers of DIW Berlin 1226, DIW Berlin, German Institute for Economic Research.
  • Handle: RePEc:diw:diwwpp:dp1226
    as

    Download full text from publisher

    File URL: https://www.diw.de/documents/publikationen/73/diw_01.c.406435.de/dp1226.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Hagist, Christian & Klusen, Norbert & Plate, Andreas & Raffelhüschen, Bernd, 2005. "Social Health Insurance: the major driver of unsustainable fiscal policy?," Discussion Papers 133, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    2. Andreas Werblow & Stefan Felder & Peter Zweifel, 2007. "Population ageing and health care expenditure: a school of 'red herrings'?," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1109-1126.
    3. Christian Hagist & Laurence Kotlikoff, 2005. "Who's Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," NBER Working Papers 11833, National Bureau of Economic Research, Inc.
    4. Meena Seshamani & Alastair Gray, 2004. "Ageing and health‐care expenditure: the red herring argument revisited," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 303-314, April.
    5. Verbeek, Marno & Nijman, Theo, 1992. "Can Cohort Data Be Treated as Genuine Panel Data?," Empirical Economics, Springer, vol. 17(1), pages 9-23.
    6. David Roodman, 2009. "How to do xtabond2: An introduction to difference and system GMM in Stata," Stata Journal, StataCorp LP, vol. 9(1), pages 86-136, March.
    7. Victor R. Fuchs, 2018. "“Though Much Is Taken”: Reflections on Aging, Health, and Medical Care," World Scientific Book Chapters, in: Health Economics and Policy Selected Writings by Victor Fuchs, chapter 33, pages 403-424, World Scientific Publishing Co. Pte. Ltd..
    8. Harris, Richard D. F. & Tzavalis, Elias, 1999. "Inference for unit roots in dynamic panels where the time dimension is fixed," Journal of Econometrics, Elsevier, vol. 91(2), pages 201-226, August.
    9. Davidson, Russell & MacKinnon, James G., 1993. "Estimation and Inference in Econometrics," OUP Catalogue, Oxford University Press, number 9780195060119.
    10. Sally C. Stearns & Edward C. Norton, 2004. "Time to include time to death? The future of health care expenditure predictions," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 315-327, April.
    11. Breyer, Friedrich & Felder, Stefan, 2006. "Life expectancy and health care expenditures: A new calculation for Germany using the costs of dying," Health Policy, Elsevier, vol. 75(2), pages 178-186, January.
    12. Colombier, Carsten & Weber, Werner, 2009. "Projecting health-care expenditure for Switzerland: further evidence against the 'red-herring' hypothesis," MPRA Paper 26747, University Library of Munich, Germany, revised Nov 2009.
    13. Blundell, Richard & Bond, Stephen, 1998. "Initial conditions and moment restrictions in dynamic panel data models," Journal of Econometrics, Elsevier, vol. 87(1), pages 115-143, August.
    14. Friedrich Breyer & Stefan Hupfeld, 2009. "Fairness of Public Pensions and Old-Age Poverty," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 65(3), pages 358-380, September.
    15. Deaton, Angus, 1985. "Panel data from time series of cross-sections," Journal of Econometrics, Elsevier, vol. 30(1-2), pages 109-126.
    16. Tim Miller, 2001. "Increasing longevity and medicare expenditures," Demography, Springer;Population Association of America (PAA), vol. 38(2), pages 215-226, May.
    17. Hanming Fang & Michael Keane & Ahmed Khwaja & Martin Salm & Dan Silverman, 2007. "Testing the Mechanisms of Structural Models: The Case of the Mickey Mantle Effect," American Economic Review, American Economic Association, vol. 97(2), pages 53-59, May.
    18. Peter Zweifel & Lukas Steinmann & Patrick Eugster, 2005. "The Sisyphus Syndrome in Health Revisited," International Journal of Health Economics and Management, Springer, vol. 5(2), pages 127-145, June.
    19. Andreas Werblow & Stefan Felder & Peter Zweifel, 2007. "Population ageing and health care expenditure: a school of ‘red herrings’?," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1109-1126, October.
    20. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    21. Karlsson, Martin & Klohn, Florian, 2011. "Some notes on how to catch a red herring: Ageing, time-to-death & care costs for older people in Sweden," Darmstadt Discussion Papers in Economics 207, Darmstadt University of Technology, Department of Law and Economics.
    22. Christian Hagist & Norbert Klusen & Andreas Plate & Bernd Raffelhüschen, 2005. "Social Health Insurance - the Major Driver of Unsustainable Fiscal Policy?," CESifo Working Paper Series 1574, CESifo.
    23. van Baal, Pieter H. & Wong, Albert, 2012. "Time to death and the forecasting of macro-level health care expenditures: Some further considerations," Journal of Health Economics, Elsevier, vol. 31(6), pages 876-887.
    24. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496, September.
    25. Im, Kyung So & Pesaran, M. Hashem & Shin, Yongcheol, 2003. "Testing for unit roots in heterogeneous panels," Journal of Econometrics, Elsevier, vol. 115(1), pages 53-74, July.
    26. Karlsson, Martin & Klohn, Florian, 2011. "Some notes on how to catch a red herring - Ageing, time-to-death and care costs for older people in Sweden," HERO Online Working Paper Series 2011:6, University of Oslo, Health Economics Research Programme.
    27. David Roodman, 2006. "How to Do xtabond2," North American Stata Users' Group Meetings 2006 8, Stata Users Group.
    28. Hans-Martin von Gaudecker & Rembrandt D. Scholz, 2007. "Differential mortality by lifetime earnings in Germany," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 17(4), pages 83-108.
    29. Verbeek, M.J.C.M. & Nijman, T.E., 1992. "Can cohort data be treated as genuine panel data?," Other publications TiSEM d4eada8f-b91c-4fe7-a58c-7, Tilburg University, School of Economics and Management.
    30. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 58(2), pages 277-297.
    31. Felder, Stefan & Werblow, Andreas & Zweifel, Peter, 2010. "Do red herrings swim in circles? Controlling for the endogeneity of time to death," Journal of Health Economics, Elsevier, vol. 29(2), pages 205-212, March.
    32. Hagist, Christian & Klusen, Norbert & Plate, Andreas & Raffelhüschen, Bernd, 2005. "Social health insurance: The major driver of unsustainable fiscal policy?," FZG Discussion Papers 1, University of Freiburg, Research Center for Generational Contracts (FZG).
    33. Mickael Bech & Terkel Christiansen & Ehsan Khoman & Jørgen Lauridsen & Martin Weale, 2011. "Ageing and health care expenditure in EU-15," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(5), pages 469-478, October.
    34. Baoping Shang & Dana Goldman, 2008. "Does age or life expectancy better predict health care expenditures?," Health Economics, John Wiley & Sons, Ltd., vol. 17(4), pages 487-501, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Friedrich Breyer & Normann Lorenz, 2021. "The “red herring” after 20 years: ageing and health care expenditures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 661-667, July.
    2. Breyer Friedrich, 2015. "Demographischer Wandel und Gesundheitsausgaben: Theorie, Empirie und Politikimplikationen," Perspektiven der Wirtschaftspolitik, De Gruyter, vol. 16(3), pages 215-230, October.
    3. Melberg, Hans Olav & Sørensen, Jan, 2013. "How does end of life costs and increases in life expectancy affect projections of future hospital spending?," HERO Online Working Paper Series 2013:9, University of Oslo, Health Economics Research Programme.
    4. Maciej Lis, 2015. "Red Herring in the Vistula River: Time-to-Death and Health Care Expenditure," IBS Working Papers 13/2015, Instytut Badan Strukturalnych.
    5. Stefan Felder, 2013. "The Impact of Demographic Change on Healthcare Expenditure," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(1), pages 03-06, 04.
    6. Atella, Vincenzo & Conti, Valentina, 2014. "The effect of age and time to death on primary care costs: The Italian experience," Social Science & Medicine, Elsevier, vol. 114(C), pages 10-17.
    7. Karlsson, Martin & Klohn, Florian, 2011. "Some notes on how to catch a red herring - Ageing, time-to-death and care costs for older people in Sweden," HERO Online Working Paper Series 2011:6, University of Oslo, Health Economics Research Programme.
    8. Joan Costa‐Font & Cristina Vilaplana‐Prieto, 2020. "‘More than one red herring'? Heterogeneous effects of ageing on health care utilisation," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 8-29, October.
    9. repec:ces:ifodic:v:11:y:2013:i:1:p:19078503 is not listed on IDEAS
    10. Karlsson, Martin & Klohn, Florian, 2011. "Some notes on how to catch a red herring Ageing, time-to-death & care costs for older people in Sweden," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 77470, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    11. Maria Ana Matias & Rita Santos & Panos Kasteridis & Katja Grasic & Anne Mason & Nigel Rice, 2022. "Approaches to projecting future healthcare demand," Working Papers 186cherp, Centre for Health Economics, University of York.
    12. Vincenzo Atella & Valentina Conti, 2013. "The effect of age and time to death on health care expenditures: the Italian experience," CEIS Research Paper 267, Tor Vergata University, CEIS, revised 12 Nov 2013.
    13. Fabio Pammolli & Francesco Porcelli & Francesco Vidoli & Monica Auteri & Guido Borà, 2017. "La spesa sanitaria delle Regioni in Italia - Saniregio2017," Working Papers CERM 01-2017, Competitività, Regole, Mercati (CERM).
    14. Mauro Laudicella & Paolo Li Donni & Kim Rose Olsen & Dorte Gyrd‐Hansen, 2022. "Age, morbidity, or something else? A residual approach using microdata to measure the impact of technological progress on health care expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1184-1201, June.
    15. Moore, Patrick V. & Bennett, Kathleen & Normand, Charles, 2017. "Counting the time lived, the time left or illness? Age, proximity to death, morbidity and prescribing expenditures," Social Science & Medicine, Elsevier, vol. 184(C), pages 1-14.
    16. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    17. Avalosse, Hervé & Denuit, Michel & Lucas, Nathalie, 2020. "Hospital inpatients costs dynamics at older ages: A frequency-severity approach," LIDAM Discussion Papers ISBA 2020027, Université catholique de Louvain, Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA).
    18. Stefan Felder, 2013. "The Impact of Demographic Change on Healthcare Expenditure," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(01), pages 03-06, April.
    19. Kasteridis, Panagiotis & Rice, Nigel & Santos, Rita, 2022. "Heterogeneity in end of life health care expenditure trajectory profiles," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 221-251.
    20. Viktor von Wyl & Konstantin Beck, 2014. "Risk adjustment in aging societies," Health Economics Review, Springer, vol. 4(1), pages 1-14, December.
    21. Siciliani Luigi, 2013. "The Economics of Long-Term Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 343-375, August.

    More about this item

    Keywords

    Health care expenditures; ageing; longevity; 5-year survival rate;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • I19 - Health, Education, and Welfare - - Health - - - Other

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:diw:diwwpp:dp1226. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Bibliothek (email available below). General contact details of provider: https://edirc.repec.org/data/diwbede.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.