Would Insuring Near-Elderly Persons Reduce Medicare Spending in Patients Age 65 Years or Older?
Authors: J. Michael McWilliams
Journal: Annals of Internal Medicine (2010)

Letters6 April 2010Would Insuring Near-Elderly Persons Reduce Medicare Spending in Patients Age 65 Years or Older?J. Michael McWilliams, MD, PhD, Ellen Meara, PhD, and John Z. Ayanian, MD, MPPJ. Michael McWilliams, MD, PhDFrom Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this author, Ellen Meara, PhDFrom Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this author, and John Z. Ayanian, MD, MPPFrom Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-7-201004060-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Polsky and Decker reiterate 2 concerns raised in Bhattacharya's editorial (1) regarding our article: reverse causation and unmeasured confounding. We also had these concerns as we embarked on our research. However, after using rigorous statistical methods and carefully considering the relevant clinical evidence and empirical literature, we do not believe that they pose major threats to our main conclusion.First, Drs. Polsky and Decker and Bhattacharya (1) note that poor health can cause people to lose their health insurance and that this causal sequence, rather than the reverse effects of lacking insurance on health, must explain our ...References1. Bhattacharya J. Insuring the near-elderly: how much would Medicare save? [Editorial]. Ann Intern Med. 2009;151:816-7. [PMID: 19949148] LinkGoogle Scholar2. Baker DW, Sudano JJ, Albert JM, Borawski EA, Dor A. Loss of health insurance and the risk for a decline in self-reported health and physical functioning. Med Care. 2002;40:1126-31. [PMID: 12409857] CrossrefMedlineGoogle Scholar3. McWilliams JM. Health consequences of uninsurance among adults in the United States: recent evidence and implications. Milbank Q. 2009;87:443-94. [PMID: 19523125] CrossrefMedlineGoogle Scholar4. McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Health of previously uninsured adults after acquiring Medicare coverage. JAMA. 2007;298:2886-94. [PMID: 18159058] CrossrefMedlineGoogle Scholar5. McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of medicare coverage. Ann Intern Med. 2009;150:505-15. [PMID: 19380852] LinkGoogle Scholar6. McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Assessing the health effects of Medicare coverage for previously uninsured adults: a matter of life and death? Health Serv Res. 2010. [Forthcoming]. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDifferences in Control of Cardiovascular Disease and Diabetes by Race, Ethnicity, and Education: U.S. Trends From 1999 to 2006 and Effects of Medicare Coverage J. Michael McWilliams , Ellen Meara , Alan M. Zaslavsky , and John Z. Ayanian Medicare Spending for Previously Uninsured Adults J. Michael McWilliams , Ellen Meara , Alan M. Zaslavsky , and John Z. Ayanian Insuring the Near-Elderly: How Much Would Medicare Save? Jay Bhattacharya Would Insuring Near-Elderly Persons Reduce Medicare Spending in Patients Aged 65 Years or Older? Daniel Polsky and Sandra L. Decker Metrics 6 April 2010Volume 152, Issue 7Page: 477KeywordsAdultsCardiovascular diseasesConflicts of interestDiabetes mellitusHealth economicsHealth insuranceMedicareStatistical methods ePublished: 6 April 2010 Issue Published: 6 April 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...