Consumer Expenditure Survey Anthology, 2008: Out-of-Pocket Health Care Spending Patterns of Older Americans, as Measured by the Consumer Expenditure Survey

Meaghan Duetsch The United States has experienced many changes over the past two decades in the way health care is managed, such as the shift from primarily fee-for-service type health insurance coverage to coverage through health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Health care expenditures, as a proportion of all expenditures, have increased over the last 20 years. This article examines the health care expenditures of older families in the age ranges just before and just after the Medicare eligibility age of 65 and analyzes how health care expenditures for these two groups have changed. The analysis includes an examination of health care expenditure changes over the past two decades between consumer units with reference person in the 55-64 year-old range, and so not eligible for Medicare, and consumer units with reference person in the 65-74 year-old range, whose reference person is eligible for Medicare. In the Consumer Expenditure Survey (CE), health care expenditures include health insurance, medical services, drugs, and medical supplies. Only out-of-pocket, non-reimbursed expenditures on these items are included; for example, the portion of a health insurance premium that the consumer unit pays, as opposed to the portion paid by an employer; any copayments paid by the consumer unit; and any insurance deductibles. Thus, the CE captures data on how much consumer units pay for their health care expenditures, not necessarily the total cost of the health care provided to that consumer unit. The CE also captures data on the health insurance status of the consumer unit—although this article does not include health insurance status of the consumer unit in its analysis—as well as the type of health insurance, such as PPO or HMO.