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PubMed1978

Insurance coverage and access: implications for health policy.

Data are presented from a recent survey of the United States population comparing the characteristics and levels of access to medical care of persons under 65 years who have group or individual private health insurance, public health insurance, or no third-party coverage. The uninsured group appeared to fall between the privately insured and publicly insured groups on measures of social and economic status. Persons with publicly subsidized forms of insurance coverage utilized services at the highest rates, and uninsured persons used them at the lowest rates. Neither of these groups was as satisfied with the convenience or the quality of the care it obtained as the privately insured group. Implications of these findings for national health insurance and other health policy initiatives are discussed.

Adolescent↗
PubMed1995

Health insurance coverage and receipt of preventive health services--United States, 1993.

In 1992, an estimated 38.5 million U.S. residents aged < 65 years did not have health insurance (1). Efforts by states to expand health-care coverage will require surveillance for and state-specific information about coverage for acute care and the receipt of preventive services. This report summarizes state-specific and aggregated data from the 1993 Behavioral Risk Factor Surveillance System (BRFSS) regarding the status of health insurance coverage and the receipt of preventive health services among adults aged 18-64 years. In addition, findings from the analysis of supplemental questions added to the BRFSS in Minnesota are included that address health-care utilization, source of health-care coverage, and coverage of children.

Adult↗
PubMed1997

Health insurance coverage at midlife: characteristics, costs, and dynamics.

Recent data from the first two waves of the Health and Retirement Study are analyzed to evaluate prevalence of different types of health insurance, characteristics of different plan types, and change sin coverage as individuals approach retirement age. Although overall rates of coverage are quite high among the middle-aged, the risk of noncoverage is high within many disadvantaged groups, including Hispanics, low-wage earners, and the recently disabled. Sixty percent of individuals with health benefits are enrolled in health maintenance organizations (HMOs) or preferred provider organizations (PPOs). In addition, one-fourth of enrollees in fee-for-service (FFS) plans report restrictions in their access to specialists.

Age Factors↗
PubMed2001

Maternal health insurance coverage as a determinant of obstetrical anesthesia care.

This study measures the association between health insurance and the likelihood of receiving different obstetrical anesthesia protocols among 121,351 singleton live births in upstate New York during 1992. Mothers receiving a cesarean under Medicaid were approximately twice as likely to receive general anesthesia as those with traditional private coverage. Those receiving a cesarean under an HMO were least likely to receive general anesthesia with adjusted odds of 0.73 (confidence interval [CI] = 0.68-0.79), compared to those with traditional private insurance. Those delivering vaginally under Medicaid, HMO, or no coverage had adjusted odds of receiving an epidural of 0.45 (CI = 0.43-0.48), 0.68 (CI = 0.64-0.71), and 0.44 (CI = 0.38-0.52), respectively, compared to those under traditional private insurance. Although there was some differences by race, the strongest determinant of anesthesia remained insurance type. Insurance-mediated disparities in obstetrical anesthesia care are evident in upstate New York and warrant further study nationally.

Adult↗
PubMed1999

A tale of 5 tests. Insurance coverage.

They promise precision in detecting cancer cells, bone breakdown, risk of heart disease, and other maladies. There's just one problem: Many insurers won't pay for these new diagnostic tools, saying they haven't yet proven themselves. "We complain, we write letters," says one doctor, who calls a new Pap test a "quantum leap" from the existing Pap smear. "I'm just a little physician, crying in the woods."

Bone Resorption↗
PubMedDate not supplied

Changes in insurance coverage: 1994-2000 and beyond.

The number of uninsured Americans fell in 2000 for the second consecutive year. The reduction has been attributed to the continued expansion of employer-sponsored insurance. However, the increase in employer coverage among adults was offset by declines of other types of coverage. For children, increases in public coverage plus the growth in employer-sponsored insurance led to the reduction in the number of uninsured children. Over the longer period (1994-2000), one of great economic growth, the uninsurance rate was essentially the same at the end as at the beginning. The rate of employer-sponsored insurance increased sharply, so that more people had employer coverage. However, these increases were offset by reductions in other forms of coverage, particularly Medicaid and state-sponsored insurance and private nongroup coverage, so the overall rate of uninsurance did not change.

Adult↗