The cost of preventive health services in primary medical care and implications for health insurance coverage.
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Renewed national interest in market forces to promote more efficient and cost-conscious behavior by patients and providers increasingly focuses on the structure of private health insurance benefits. Two features of procompetitive legislative proposals are considered: a ceiling on tax-free employer insurance premiums and offering greater choice of insurance plans. The interests of efficiency and equity invoke different kinds of risks and transfers; no single institutional approach is likely to yield the promised benefits.
This paper cautions state policy analysts who estimate expected costs of state health reforms using state-specific data from general purpose, national surveys. It compares cost estimates of subsidized insurance programs for low-income uninsured persons in 10 states using the Current Population Survey (CPS) and the Robert Wood Johnson Foundation state surveys. Depending on the measure of insurance and concept of the family that are used, costs of state programs could exceed the estimates by more than 50%. State policy analysts need to be aware of such pitfalls and make appropriate adjustments when using CPS data to estimate program costs.
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