CDHA CAAR

A. “Grandpa and the Snapper: the Wellbeing of the Elderly who Live with Children,” by Angus Deaton and Arthur A. Stone (w19100, June 2013, .pdf format, 26p.).

Abstract:

Elderly Americans who live with people under age 18 have lower life evaluations than those who do not. They also experience worse emotional outcomes, including less happiness and enjoyment, and more stress, worry, and anger. In part, these negative outcomes come from selection into living with a child, especially selection on poor health, which is associated with worse outcomes irrespective of living conditions. Yet even with controls, the elderly who live with children do worse. This is in sharp contrast to younger adults who live with children, likely their own, whose life evaluation is no different in the presence of the child once background conditions are controlled for. Parents, like elders, have enhanced negative emotions in the presence of a child, but unlike elders, also have enhanced positive emotions. In parts of the world where fertility rates are higher, the elderly do not appear to have lower life evaluations when they live with children; such living arrangements are more usual, and the selection into them is less negative. They also share with younger adults the enhanced positive and negative emotions that come with children. The misery of the elderly living with children is one of the prices of the demographic transition.

www.nber.org/papers/w19100

B. “The Effect of Medicare Advantage on Hospital Admissions and Mortality,” by Christopher C. Afendulis, Michael E. Chernew, Daniel P. Kessler (w19101, June 2013, .pdf format, 27p.).

Abstract:

Medicare currently allows beneficiaries to choose between a government-run health plan and a privately- administered program known as Medicare Advantage (MA). Because enrollment in MA is optional, conventional observational estimates of the program’s impact are potentially subject to selection bias. To address this, we use a discontinuity in the rules governing MA payments to health plans that gives greater payments to plans operating in counties in Metropolitan Statistical Areas with populations of 250,000 or more. The sharp difference in payment rates at this population cutoff creates a greater incentive for plans to increase the generosity of benefits and therefore enroll more beneficiaries in MA in counties just above versus just below the cutoff. We find that the expansion of MA on this margin reduces beneficiaries’ rates of hospitalization and mortality.

www.nber.org/papers/w19101