The incidence of Medicare

The Medicare program transfers nearly $300 billion annually from taxpayers to beneficiaries. This paper considers the incidence of such transfers in the context of a life cycle model with uncertainty about future health care expenditures. We find the distributional consequences of the Medicare program are roughly neutral in dollar terms; households living in high income neighborhoods pay more in taxes, but they also receive more in benefits. These dollar flows, however, ignore the insurance value of the Medicare system. Given the incomplete insurance coverage of lower income elderly households prior to the Medicare program, the money-metric benefits to lower income groups exceed the dollar flows, suggesting that Medicare redistributes more than a simple accounting exercise would suggest. (c) 2005 Elsevier B.V. All rights reserved.