Age and Gender Differences in Health Spending

Health spending can vary significantly across demographic groups.  Two of the commonly examined attributes are age and gender.  A study in Health Affairs examines variation by those factors.  They tend to be interrelated; women make up more of the elderly population, which tends to spend more on health care.  For example, in 2004 50% of the population was female, but women accounted for 57% of spending.  Of the population over 65, however, 58% were women and for those over age 85, 70% were women.   (HA Article)

Interestingly, however, even on a per capita basis, significantly more is spent on health care for women than for men, in all age groups except children, where the disproportionate treatment of boys for ADHD and other “behavioral” issues may be to blame.  Overall it was 32% more on a per capita basis.  Some of this may be due to pregnancy and childbirth related services, which uniquely affect women.  The per capita difference was found in all care categories, but was most pronounced in nursing care.

This research raises the usual question about what is really fair in terms of how premiums are set for various groups or factors.  Many states and now the federal reform law, limit or ban significant differences in premiums for men and women.  Other than political popularity, it is a little hard to understand the rational for this.  As long as premiums are set based on actuarial justified cost expectations and past experience, it would seem fairer to everyone if those who have higher spending pay more.  Otherwise, a subsidy without a clear rational occurs.