Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 64 Page 65 Page 66 Page 67 Page 68 Page 69 Page 70 Page 71 Page 72 Page 73 Page 74 Page 75 Page 76 Page 77 Page 78 Page 79 Page 80 Page 81 Page 82 Page 83 Page 84 Page 85 Page 86 Page 87 Page 88 Page 89 Page 90 Page 91 Page 92 Page 93 Page 94 Page 95 Page 96 Page 97 Page 98 Page 99 Page 100 Page 101 Page 102 Page 103 Page 104 Page 105 Page 106 Page 107 Page 108CH APTER 1 29 with lower usage of preventive services. Looking at the same HRS data from a different perspec- tive, Dor et al. (2003) found that providing insur- ance to previously uninsured working-age adults resulted in a 7 percent improvement in overall self-reported health. Another study (McWilliams et al. 2003) analyzed differences in the receipt of basic clinical ser- vices among the continuously insured and the uninsured in 1996 and 2000—before and after respondents became eligible for Medicare at age 65. The analysis suggested that the acquisition of Medicare coverage significantly reduces the differences in the use of preventive services such as cholesterol testing, mammography, prostate examinations, and medical visits dealing with arthritis. Among adults with arthritis and/or hypertension, however, differences in the use of anti-arthritis/anti-hypertension medications between continuously insured and uninsured people were essentially unchanged after Medicare coverage began. The HRS also can tell us who has prescription drug coverage and how they use it. The new Medicare Part D prescription drug coverage program was implemented in 2006, and the HRS will provide baseline estimates and then track changes in older adults’ prescription drug coverage and use. Other studies using HRS data also offer insights about prescription drug coverage. For instance, the survey showed that in 1998, HRS respondents under age 65 were more likely than those ages 65 to 79 and much more likely than those age 80 and older to have prescription-drug insurance coverage (80 percent, 71 percent, and 59 percent, respectively) (Table 1-3). Importantly, regardless of age, people who did not have prescription drug coverage were less likely to fill all of their prescriptions. Younger respondents were less likely than older respondents to fill prescriptions, regardless of drug insurance coverage. One study suggested that this cost- cutting by seniors may pose an increased risk for adverse health outcomes (Heisler et al. 2004). Health Care Use As the U.S. population ages and Medicare expenditures continue to rise, the wealth of HRS data on use of health care services will become an increasingly important resource. Figure 1-7 Not married Married Percent Not Filling All Prescriptions Percent with Prescription Drug Coverage With Insurance Coverage Without Insurance Coverage Under 65 80% 6% 22% 65-79 71 4 11 80 and Over 59 3 7 TBL. 1-3 Prescription Drug Coverage and Likelihood of Filling prescriptions, BY AGE: 1998 Source: HRS 1998. FIG. 1-7 SERVice use in the past Two years, by age: 2002 (Percent using each type of service) 55-64 65-74 75-84 85+ Hospital Nursing Home Dental Care Home Health 0% 10% 20% 30% 60% 40% 50% 70%