Financial and Life Planning Resource Directory

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Money: Health care costs, insurance
Consumers/clients
	Abaluck, Jason T., and Gruber, Jonathan, Choice Inconsistencies among the Elderly: Evidence from Plan Choice in the Medicare Part D Program
		National Bureau of Economic Research Working Papers, February 2009, $5.00 http://papers.nber.org/papers/w14759 Abaluck and Gruber report that Medicare participants typically make poor decisions about which prescription drug plan to use, focusing too much on premiums and not enough on net cost. They suggest limiting choices to those that are financially best.
	Butrica, Barbara A., et al, Do Health Problems Reduce Consumption at Older Ages?
		Boston College Center for Retirement Research, March 2009, Free http://crr.bc.edu/images/stories/Working_Papers/wp_2009-9.pdf The authors find that health problems do not reduce non-health expenses for people of Medicare age, but do reduce non-health expenses for lower-income people below that age, suggesting that holes in medical care financing are at fault.
	Buttell, Amy E., "Guiding Clients Through the Transition to Medicare", Journal of Financial Planning, March 2010 (Vol. 23, No 3)
		Buttell includes information on how to acquire Medicare expertise and stay on top of changes.
	Cubanski, Juliette, et al, Healthcare on a Budget: An Analysis of Spending by Medicare Households
		Henry J. Kaiser Family Foundation, February 2009, Free http://www.kff.org/medicare/upload/7859.pdf Among the authors' findings is that Medicare households spend more than three times on healthcare what non-Medicare households spend, as a percentage of total household expenses.
	Curry, Leslie A., et al, "Individual Decision Making in the Non-Purchase of Long-Term Care Insurance", Gerontologist, August 2009 (Vol. 49, No. 4)
		http://gerontologist.oxfordjournals.org/cgi/content/abstract/49/4/560 People tend not to purchase long-term care insurance based on: policy, the viability and integrity of private insurance companies, family dynamics, psychological responses, and feelings of being overwhelmed and inadequately informed.
	Employers, Workers, and the Future of Employment-Based Health Benefits
		Employee Benefits Research Institute, December 2009, Free http://www.ebri.org/pdf/briefspdf/EBRI_IB_02-2010_No339_EB-Bens.pdf Summary of presentations at EBRI’s 65th biannual policy forum, held in Washington, DC, Decmber 10, 2009.
	Engelhardt, Gary V., and Gruber, Jonathan, Medicare Part D and the Financial Protection of the Elderly
		Boston College Center for Retirement Research, October 2009, Free http://crr.bc.edu/images/stories/Working_Papers/wp_2009-24.pdf Engelhardt and Gruber estimate that the extension of Part D benefits resulted in 75% crowd-out of prescription drug insurance coverage, and 33%-50% crowd-out of prescription drug expenditures of those 65 and older. Part D is associated with relatively small reductions in out-of-pocket spending.
	Felland, Laurie E., and Reschovsky, James D., More Nonelderly Americans Face Prob-lems Affording Prescription Drugs
		Center for Studying Health System Changes, January 2009, Free http://www.hschange.com/CONTENT/1039/ The authors found that in 2007, one in seven Americans under age 65 reported not filling a prescription in the previous year because they couldn’t afford the medication, up from one in 10 in 2003.
	Ferguson, Gary A., Medigap Policyholders Survey
		AHIP (America’s Health Insurance Plans) and Blue Cross / Blue Shield of Chicago, May 2009, Free http://www.bcbs.com/issues/medicare/background/Medigap-Enrollees-Presentation-June-09.ppt According to this report, most Medigap insurance policyholders are happy with their policies.
	Friedberg, Leora, How Much Do Older Workers Value Employee Health Insurance?
		Boston College Center for Retirement Research, July 2008, Free http://crr.bc.edu/images/stories/Briefs/ib_8-9.pdf The authors surveyed older workers and analyzed by ethnic group the factors that influence the presence or absence of health insurance.
	Hidden Link, The: Health Costs and Family Economic Insecurity
		Families USA, January 2009, Free http://www.familiesusa.org/assets/pdfs/the-hidden-link.pdf An excellent summary of issues relating to health care costs and family financial security.
	Individual Health Insurance 2009: A Comprehensive Survey of Premiums, Availability, and Benefits
		AHIP Center for Policy Research, October 2009, Free http://www.ahipresearch.org/pdfs/2009IndividualMarketSurveyFinalReport.pdf This report indicates that individual health insurance is more widely available and at a better price than is generally recognized.
	Johnson, Richard W., and Mommaerts, Corina, Are Health Care Costs a Burden for Older Americans?
		Urban Institute, July 2009, Free http://www.urban.org/uploadedpdf/411924_health_care_burden.pdf The authors report that Medicare Part D has significantly reduced the proportion of income older Americans spend on health care. Most now spend less than one-eighth of income on health care, mostly for premiums, though for the poor this proportion is often closer to one-fifth.
	Johnson, Richard W., and Mommaerts, Corina, Will Health Care Costs Bankrupt Aging Boomers?
		Urban Institute, February 2010, Free http://www.urban.org/uploadedpdf/412026_health_care_costs.pdf Johnson and Mommaets discuss retiree health costs in terms of annual rather than lifetime costs, but their projections are quite dire just the same.
	Lewin Group, Americans at Risk: One in Three Uninsured
		Families USA, March 2009, Free http://www.familiesusa.org/assets/americans-at-risk.pdf Using census data, The Lewin Group found that 86.7 million Americans were uninsured during at least part of 2007 or 2008.
	Medicare & Medicaid Statistical Supplement - Details for Personal Health Care Expenditures (U.S. Centers on Medicare and Medicaid Services)
		http://www.cms.hhs.gov/MedicareMedicaidStatSupp/LT/itemdetail.asp?filter-Type=none&filterByDID=0&sortByDID=2&sortOrder=descending&itemID=CMS1218816&intNumPerPage=10, Free Data on personal health expenditures by sources of funds and by type of expenditure.
	Medicare Advantage: CMS Assists Beneficiaries Affected by Inappropriate Marketing but Has Limited Data on Scope of Issue
		U.S. General Accounting Office, December 2009, Free http://www.gao.gov/new.items/d1036.pdf This report documents the volume and kinds of problems the Centers for Medi-care and Medicaid have dealt with in this area, but notes that no general survey has documented the extent of the problems.
	Medicare Basics
		U.S. Centers for Medicare and Medicaid Services, 2009, Free http://www.medicare.gov/Publications/Pubs/pdf/11034.pdf Consumer booklet, printable free online
	Medicare health and drug plans state by state (U.S. Centers for Medicare and Medicaid Services)
		http://www.cms.hhs.gov/Partnerships/downloads/statefactsheets_all.pdf, Free Fact sheets on Medicare health and drug plans state by state.
	Monk, Courtney, and Munnell, Alicia H., Implications of Declining Retiree Health Insurance, The
		Boston College Center for Retirement Research, August 2009, Free http://crr.bc.edu/images/stories/Working_Papers/wp_2009-15.pdf The authors conclude that a full elimination of employer-sponsored health benefits would primarily affect early retirees who would face the cost of much more expensive insurance or of financing illness without insurance, particularly prior to Medicare eligibility.
	Sun, Wei, et al, Does Staying Healthy Reduce Your Lifetime Health Care Costs?
		Boston College Center for Retirement Research, May 2010, Free http://crr.bc.edu/images/stories/Briefs/ib_10-8.pdf The authors find that that although the current health care costs of healthy retirees are lower than those of the unhealthy, the healthy actually face higher total health care costs over their remaining lifetime.
	Trends in Health Care Expenditures for Adults Ages 45-64: 2006 versus 1996
		U.S. Agency for Healthcare Research and Quality (Dept. of Health and Human Services), August 2009, Free http://www.meps.ahcpr.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&opt=2&id=917 Documents a 40% increase in costs, after inflation
	Trends in Health Care Expenditures for the Elderly Age 65 and over: 2006 versus 1996
		U.S. Agency for Healthcare Research and Quality (Dept. of Health and Human Services), August 2009, Free http://www.meps.ahcpr.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&opt=2&id=918 Documents a 30% increase in costs, after inflation
	Umans, Ben, and Nonnemaker, K. Lynne, Medicare Beneficiary Population, The
		American Association for Retired Persons, 2009, Free http://assets.aarp.org/rgcenter/health/fs149_medicare.pdf This report examines the demographics of U.S. Medicare recipients, as well as utilization and spending patterns, and discusses possible future changes in these measures
	Use of Health Savings Accounts for Health Care in Retirement, The
		Employee Benefits Research Institute, April 2010, Free http://www.ebri.org/pdf/notespdf/EBRI_Notes_04-Apr10.HSAs-TaxExpends1.pdf This stuidy demonstrates that Health Savings Accounts, though intended for use by retirees, are limited to only a minor role in funding retirement health care, because of statutory limits on the plans, and the magnitude of typical health care costs in retirement
	Webb, Anthony, and Zhivan, Natalia, What Is the Distribution of Lifetime Health Care Costs From Age 65?
		Boston College Center for Retirement Research, March 2010, Free http://crr.bc.edu/images/stories/Briefs/ib_10-4.pdf The expected present value of lifetime uninsured health care costs for a typical married couple age 65 is about $197,000, with a 5-percent risk that it will exceed $311,000. With nursing care included, the number increases to $260,000, with a 5-percent risk of exceeding $570,000.
	What’s in the Stars? Quality Ratings of Medicare Advantage Plans, 2010
		Kaiser Family Foundation, December 2009, Free http://www.kff.org/medicare/upload/8025.pdf Analyzing the ratings of plans by the U.S. Centers for Medicare and Medicaid Services, Kaiser finds that the highest rated plans tend to be offered by not-for-profits and tend to be older plans. In some states, as few as 2% of participants are enrolled in the highly rated plans.
	Yakoboski, Paul J., Meeting Health Care Expenses in Retirement: How Ready Are Near-Retirees?
		TIAA-CREF, December 2009, Free http://www.tiaa-crefinsti-tute.org/pdf/research/trends_issues/ti_healthcare1209.pdf Yakoboski finds that despite relatively high levels of concern among older employees in higher ed institutions, relatively few have actually discussed meeting health care expenses in retirement with a financial advisor, although they recognize that this would be beneficial.
	Your Medical Bills: A Consumer’s Guide to Coping with Medical Debt
		Families USA, 2009, Free http://www.familiesusa.org/assets/pdfs/coping-with-medical-debt.pdf This booklet covers steps for paying one’s medical bills, understanding one’s rights, and other information needed by people struggling with medical debt.
Advisers
	Armes, David, "Long-Term Approaches to Managing Retirement Healthcare Costs", Journal of Financial Planning, December 2009 (Vol. 22, No. 12)
		Armes explains how advisers can evaluate the various options by estimating the price of excellent insurance, and identifying which coverage options (especially catastrophic protection) are important to a given client.