Three decades of health care use by the elderly, 1965-1998

Over the past three decades health spending and hospital use increased more for the elderly than for persons under age sixty-five. Medicare spending f or the oldest old (age eighty-five and older) increased faster than for per sons ages sixty-five to seventy-four, but that increase was due entirely to greater postacute care use. Health care trends are consistent with the ide a that Medicare has improved the health of the elderly. Greater spending in creases for the elderly may reflect legislative developments such as the pa ssage of Medicare and its continued fee-for-service nature and the failure to pass universal coverage, as well as changes in the health care delivery system such as the rapid growth in managed care enrollment among persons un der age sixty-five.