The Effects of Wealth on Health Care Spending: Evidence from the Housing Market

The U.S. healthcare system requires substantial out-of-pocket payments by most consumers, which can prevent some from receiving needed medical services. Recent policy proposals seek to address this problem by increasing government health care spending in order to reduce out-of-pocket costs. The social value of these policies rests in part on the extent to which consumers face credit constraints in financing medical spending. We present a novel analysis of whether elderly households face such credit constraints by estimating the effects of wealth variation from home price changes on out-of-pocket medical expenditures. Using data from the Health and Retirement Study and various measures of home price changes, we find no evidence that housing wealth impacts out-of-pocket medical spending. The estimates are universally small and precise, allowing us to rule out even modest-sized effects. Effects are zero across the expenditure distribution, for specific categories of expenditure, and for different types of consumers split by health insurance status and SES. Our results suggest that further subsidizing health care for elderly homeowners, the majority of older Americans, would increase moral hazard costs without increasing access to needed care.