House, Donald Reed (2005-11). The cost of dying on Medicare: an analysis of expenditure data. Doctoral Dissertation. Thesis uri icon


  • Roughly one third of Medicare expenditures are made on behalf of beneficiaries in their terminal year, though only five percent of the Medicare-covered population dies annually. Per-capita spending on decedents is as much as six times the level of spending on survivors. The demographic, technological and political trends that will determine the future path of spending on terminal-year beneficiaries have important implications for the fiscal well-being of the Medicare program, and by extension, the American taxpayer. Coming to an understanding of the moving parts that will control the path of the cost of dying on Medicare is vital for careful consideration of Medicare??s future, and for any discussions about further reform of the program. Analysis of expenditures in the terminal year must be made while keeping in mind the fact that major expenditures are often made in surviving years. The spike in spending in the terminal period rightly focuses attention to expenditures near death, but also we should proceed in its analysis keeping in mind that it is not the only spell of elevated medical spending for a typical individual. Given those cautions, however, the cost of dying on Medicare stands as an important area of economic inquiry and policy consideration. As total Medicare expenditures top a quarter trillion dollars, the third of that spending which covers treatments in beneficiaries?? terminal years ought to be understood more fully than it is currently.

publication date

  • August 2005