How American Old-Age Mortality Does Since Medicare Implementation, as Compared to Some European Countries

France Meslé, Institut National d'Études Démographiques (INED)
Jacques Vallin, Institut National d'Études Démographiques (INED)

In the sixties, Medicare, a new system of federal health insurance started in the US for older people. Did that event influence mortality trends ? Looking at US life tables series, it seems that increase in life expectancy at age 65 accelerated from the end of the sixties. Is it actually due to Medicare or only to the cardiovascular revolution that occurred in the same time almost everywhere in the industrialized countries ? A possible strategy to make the point clearer is to compare US mortality trends to those of some European countries, where the health system did not change. From this point of view, American trends are quite unfavorable, especially for females but before concluding that Medicare was unsuccessful, it is necessary to look at other possible explanations : data quality, impact of ethnic differentials, specific gender American issues or American failure at a new step of health transition.