@article {13203,
	title = {Risk of Large Medical Expenditures at Older Ages and Their Impact on Economic Well-being},
	year = {2023},
	institution = {University of Michigan Retirement and Disability Research Center},
	address = {Ann Arbor, Michigan},
	abstract = {We study out-of-pocket (OOP) medical expenditure risk of the U.S. population ages 55 and older using data from the Health and Retirement Study and its supplemental survey on household spending. We document trends in individual-level OOP spending from 1998 to 2018, both at the median and 95th percentile, showing a large increase until 2004, followed by rapid declines, so that 2018 OOP was less than 1998 OOP spending. We show how these changes impacted the budget share of OOP as a fraction of total household spending and analyze how households adjust the composition of their spending as OOP expenses vary. Because the distribution of OOP expenses is skewed, households face a non-negligible risk of incurring a large expense. We examined the extent to which OOP medical expenditures contribute to economic hardship among older households, as measured by food insecurity and skipping medications because of cost. We found a weak relationship with respect to food insecurity, suggesting that government programs, like Medicaid, help protect against OOP risk leading to such as an extreme form of hardship. However, we obtained statistically significant and economically meaningful effects with respect to medication insecurity: An increase from the 10th to the 90th percentile in OOP spending would increase the probability of medication insecurity by about 15 percentage points. When asked about their perceived OOP risk, individuals tend to substantially overestimate the chances of large OOP spending, although less so at advanced ages; prior experience with OOP expenses seems to lead to more accurate expectations.},
	keywords = {economic well-being, medical expenditures, Older ages},
	url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp457.pdf},
	author = {Susann Rohwedder and P{\'e}ter Hudomiet and Michael D Hurd}
}
@article {Hurd2020117,
	title = {Reducing cross-wave variability in survey measures of household wealth},
	journal = {Journal of Economic and Social Measurement},
	volume = {44},
	year = {2020},
	note = {cited By 0},
	pages = {117-139},
	abstract = {Survey measures of household wealth often incorporate measurement error. The resulting excess variability in the first difference in wealth makes meaningful statistical inference difficult on changes in household-level wealth. We study the effects of two methods intended to reduce this problem: Asset verification confronts respondents with large discrepancies between wealth reports from the current wave and from the previous wave. Cross-wave imputation uses adjacent wave information in the imputation procedures for missing data. In the U.S. Health and Retirement Study, the corrections from asset verification substantially reduced wave-To-wave changes in wealth. The cross-wave imputations also reduced variation, but to a lesser extent. {\textcopyright} 2019-IOS Press and the authors. All rights reserved.},
	keywords = {household income, Panel data, social structure, survey design, United States},
	issn = {07479662},
	doi = {10.3233/JEM-190465},
	author = {Michael D Hurd and Erik Meijer and Moldoff, Michael and Susann Rohwedder}
}
@article {9908,
	title = {The relationship between lifetime out-of-pocket medical expenditures, dementia, and socioeconomic status in the U.S},
	journal = {The Journal of the Economics of Ageing},
	volume = {14},
	year = {2019},
	pages = {100181},
	type = {Journal},
	abstract = {Dementia is one of the most expensive medical conditions. The costs are borne by families, by private insurance and by society via public programs such as Medicaid in the U.S.. There is extensive research on the relationship between dementia and annual medical spending. This paper, instead, estimates cumulative lifetime medical expenditures that can be attributed to the onset of dementia using a nationally representative longitudinal survey from the U.S., the Health and Retirement Study. The lifetime expenditures are estimated by summing any out-of-pocket medical spending reported in the panel from age 65 to death. Censored cases are imputed using a non-parametric matching algorithm called splicing. For example, survivors to the most recent wave are matched to similar individuals from older cohorts who are observed at the relevant ages all the way through death. We find that those who live with dementia for at least half a year pay, on average, $38,540 more out of pocket from age 65 to death when controlling for length of life, demographics, lifetime earnings and comorbidities. The costs of dementia are almost exclusively due to spending on nursing homes. Spending on drugs, doctor visits or hospitals, is not significantly related to dementia. The lifetime costs of dementia are significantly larger for white and rich individuals, perhaps because they use higher quality nursing homes and because they have more financial resources to spend down before becoming eligible for Medicaid support.},
	keywords = {Cognitive Ability, Dementia, Medical Expenses, Out-of-pocket payments, Socioeconomic factors},
	issn = {2212828X},
	doi = {10.1016/j.jeoa.2018.11.006},
	url = {https://www.sciencedirect.com/science/article/pii/S2212828X18300690},
	author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder}
}
@article {5733,
	title = {The Retirement Consumption Puzzle: Actual Spending Change in Panel Data},
	number = {13929},
	year = {2008},
	institution = {National Bureau of Economic Research},
	address = {Cambridge, MA},
	abstract = {The simple one-good model of life-cycle consumption requires that consumption be continuous over retirement; yet prior research based on partial measures of consumption or on synthetic panels indicates that spending drops at retirement, a result that has been called the retirement-consumption puzzle. Using panel data on total spending, nondurable spending and food spending, we find that spending declines at small rates over retirement, at rates that could be explained by mechanisms such as the cessation of work-related expenses, unexpected retirement due to a health shock or by the substitution of time for spending. In the low-wealth population where spending did decline at higher rates, the main explanation for the decline appears to be a high rate of early retirement due to poor health. We conclude that at the population level there is no retirement consumption puzzle in our data, and that in subpopulations where there were substantial declines, conventional economic theory can provide the main explanation.},
	keywords = {Event History/Life Cycle, Health Conditions and Status, Retirement Planning and Satisfaction},
	doi = {10.3386/w13929},
	author = {Michael D Hurd and Susann Rohwedder}
}
@article {5538,
	title = {The Retirement-Consumption Puzzle: Anticipated and Actual Declines in Spending at Retirement},
	number = {9586},
	year = {2003},
	institution = {The National Bureau of Economic Research},
	address = {Cambridge, MA},
	abstract = {The simple one-good model of life-cycle consumption requires consumption smoothing. However, British and U.S. households apparently reduce consumption at retirement and the reduction cannot be explained by the life-cycle model. An interpretation is that retirees are surprised by the inadequacy of resources. This interpretation challenges the life-cycle model where consumers are forward looking. However, data on anticipated consumption changes at retirement and on realized consumption changes following retirement show that the reductions are fully anticipated. Apparently the decline is due to the cessation of work-related expenses and the substitution of home production for market-purchased goods and services.},
	keywords = {Consumption and Savings, Retirement Planning and Satisfaction},
	doi = {10.3386/w9586},
	author = {Michael D Hurd and Susann Rohwedder}
}
