@inbook {5187, title = {Saving, Public Policy, and Late-Life Inequality}, booktitle = {Focus on Economic Outcomes in Later Life: Public Policy, Health, and Cummulative Advantage}, series = {Annual Review of Gerontology and Geriatrics}, volume = {22}, year = {2003}, note = {RDA 1998-006 (Lusardi) ProCite field 6 : Chapter 10 in ProCite field 8 : eds.}, pages = {207-238}, publisher = {Springer Publishing Company}, organization = {Springer Publishing Company}, chapter = {10}, address = {New York, NY}, keywords = {Consumption and Savings, Public Policy}, doi = {10.1891/0198-8794.22.1.207}, author = {Annamaria Lusardi and Jonathan S Skinner and Steven F Venti}, editor = {Crystal, Stephen and Dennis G. Shea} } @book {5266, title = {Annual Review of Gerontology and Geriatrics: Economic Outcomes in Later Life}, volume = {22}, year = {2002}, note = {ProCite field 8 : eds}, publisher = {Springer Publishing Co., Inc.}, organization = {Springer Publishing Co., Inc.}, address = {New York}, abstract = {Leading scholars focus on the economics of aging, with a particular emphasis on the economic future of the baby boom generation. Key themes include the influence of early advantages on later-life economic outcomes (the cumulative advantage/cumulative disadvantage hypothesis); the relationship between inequalities in economic status and inequalities in health status and access to health care; and the consequences of societal choices concerning retirement income systems and policies for financing acute and long-term health care.}, keywords = {Healthcare, Net Worth and Assets}, author = {Crystal, Stephen and Dennis G. Shea} } @article {6676, title = {Pension Wealth at Midlife: Comparing Self-Reports with Provider Data}, journal = {Review of Income and Wealth}, volume = {461}, year = {2000}, note = {ProCite field 3 : Urban Institute; Rutgers U; Rutgers U}, pages = {59-83}, publisher = {461}, abstract = {This paper evaluates the accuracy of estimates of pension wealth based on self-reports by comparing them to estimates based on provider data. Using data from the Health and Retirement Study, we found that few workers are well informed about their future pension benefits. Self-reports were often incomplete and typically varied widely from those based on information from providers. In defined benefit (DB) plans, discrepancies were greatest for workers who had limited education, earned low wages, and did not expect to retire soon. Differences in median pension wealth were smaller at the aggregate level than the individual level, because individual differences tended to offset each other when aggregated. Provider data appear better than self-reports for DB plans, but not for defined contribution (DC) plans. Where both are available, the best method of computing pension wealth may be to estimate DB wealth from provider data and to estimate DC wealth from self -reports.}, keywords = {Employment and Labor Force, Methodology, Net Worth and Assets, Pensions, Retirement Planning and Satisfaction}, doi = {10.1111/j.1475-4991.2000.tb00391.x}, author = {Richard W. Johnson and Sambamoorthi, Usha and Crystal, Stephen} } @article {6698, title = {Uninsured status and out-of-pocket costs at midlife.}, journal = {Health Serv Res}, volume = {35}, year = {2000}, month = {2000 Dec}, pages = {911-32}, publisher = {35}, abstract = {

OBJECTIVE: To investigate how baseline health insurance coverage affects subsequent out-of-pocket costs and utilization of health services over a two-year period.

DATA SOURCE: The first two waves of the Health and Retirement Study, a nationally representative survey of the noninstitutionalized population, ages 51 to 61 at baseline. Interviews were conducted in 1992 and 1994. Our sample consisted of 7,018 respondents who did not report public insurance as their sole source of coverage at baseline.

STUDY DESIGN: We compared self-reports of physician visits, hospitalizations, and out-of-pocket health care costs, measured as payments to physicians, hospitals, and nursing homes, by type of insurance coverage at the beginning of the period. We estimated multivariate models of costs and service use to control for individual health, demographic, and economic characteristics and employed instrumental variable techniques to account for the endogeneity of insurance coverage.

PRINCIPAL FINDINGS: Controlling for personal characteristics and accounting for the endogeneity of insurance coverage, persons at midlife with job-related health benefits went on to spend only about $50 per year less in out-of-pocket payments for health services than persons who lacked health insurance at the beginning of the period. However, they spent about $650 more per year in insurance premiums than the uninsured. The uninsured used relatively few health services, except when they were seriously ill, in which case they were likely to acquire public insurance.

CONCLUSIONS: The medically uninsured appear to avoid substantial out-of-pocket health care costs by using relatively few health services when they are not seriously ill, and then relying upon health care safety nets when they experience medical problems. These results suggest that the main impact of non-insurance at midlife is not to place the locus of responsibility for costly health care upon individuals. Instead, it discourages routine care and transfers the costs of care for severe health events to other payers. Our findings on the high cost of employment-based coverage are consistent with evidence that the proportion of workers accepting health benefits from employers has been declining in recent years.

}, keywords = {Age Factors, Female, Financing, Personal, Health Care Surveys, Health Services, Health Status, Humans, Insurance Coverage, Insurance, Health, Longitudinal Studies, Male, Medically Uninsured, Middle Aged, Models, Econometric, Multivariate Analysis, Surveys and Questionnaires, United States}, issn = {0017-9124}, author = {Richard W. Johnson and Crystal, Stephen} } @article {6644, title = {Gender differences in pension wealth: estimates using provider data.}, journal = {Gerontologist}, volume = {39}, year = {1999}, month = {1999 Jun}, pages = {320-33}, publisher = {39}, abstract = {

Information from pension providers was examined to investigate gender differences in pension wealth at midlife. For full-time wage and salary workers approaching retirement age who had pension coverage, median pension wealth on the current job was 76\% greater for men than women. Differences in wages, years of job tenure, and industry between men and women accounted for most of the gender gap in pension wealth on the current job. Less than one third of the wealth difference could not be explained by gender differences in education, demographics, or job characteristics. The less-advantaged employment situation of working women currently in midlife carries over into worse retirement income prospects. However, the gender gap in pensions is likely to narrow in the future as married women{\textquoteright}s employment experiences increasingly resemble those of men.

}, keywords = {Female, Humans, Male, Occupations, Pensions, Sex Factors, United States, Women, Working}, issn = {0016-9013}, doi = {10.1093/geront/39.3.320}, author = {Richard W. Johnson and Sambamoorthi, Usha and Crystal, Stephen} } @article {6575, title = {Health insurance coverage at midlife: characteristics, costs, and dynamics.}, journal = {Health Care Financ Rev}, volume = {18}, year = {1997}, month = {1997 Spring}, pages = {123-48}, publisher = {18}, type = {Journal}, abstract = {

Recent data from the first two waves of the Health and Retirement Study are analyzed to evaluate prevalence of different types of health insurance, characteristics of different plan types, and change sin coverage as individuals approach retirement age. Although overall rates of coverage are quite high among the middle-aged, the risk of noncoverage is high within many disadvantaged groups, including Hispanics, low-wage earners, and the recently disabled. Sixty percent of individuals with health benefits are enrolled in health maintenance organizations (HMOs) or preferred provider organizations (PPOs). In addition, one-fourth of enrollees in fee-for-service (FFS) plans report restrictions in their access to specialists.

}, keywords = {Age Factors, Costs and Cost Analysis, Demography, Female, Health Benefit Plans, Employee, Health Care Surveys, Humans, Insurance Coverage, Insurance, Health, Logistic Models, Longitudinal Studies, Male, Middle Aged, United States}, issn = {0195-8631}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194511/}, author = {Richard W. Johnson and Crystal, Stephen} } @article {5330, title = {Employer-Provided Health Benefits Among Middle-Aged Americans: Coverage Patterns and Transitions}, year = {1996}, institution = {Washington, DC, Department of Labor, Pension and Welfare Benefits Administration}, keywords = {Medicare/Medicaid/Health Insurance}, author = {Crystal, Stephen and Richard W. Johnson} }