Comments on “Informal Care and Medicare Expenditures”

1. Comments on “Informal Care and Medicare Expenditures” Jeffrey Smith University of Michigan

2. Theory • The model has been mislaid • Is this problem best thought of as “the effect” of informal care on Medicare? • Defining the object of interest in terms of a (very simple) model • What is the primary source of empirical variation within the model: preferences or constraints?

3. Estimation • Causal effect of home care last period on Medicare expenditures this period? • Reduced form relationship between current home care and current Medicare expenditures?

4. Heterogeneous treatment effects (or slopes) • Issues with nature of parameter you want to estimate. • Different instruments identify different parameters. • Combining instruments identifies a weighted average of the parameters identified by the individual instruments

5. Measurement error in informal care • Is anything known about this? • Errors in reporting hours • Variation in relation between hours and effective units of care among individuals • What are the instruments doing?

6. Big picture • Important problem • Thoughtful analysis • Es gibt mehr zu tun