Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Insurance”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed2002

Latino adults' health insurance coverage: an examination of Mexican and Puerto Rican subgroup differences.

Lack of health insurance is a serious problem in the United States. Using data from the 1996 Medical Expenditure Panel Survey, this paper examines how insurance varies between black, white, and Latino adults. Because Latino subgroups are not homogeneous, the paper also compares the factors associated with health insurance status for Mexican and Puerto Rican adults. Results indicate that access to private health insurance for Latino adults was more closely associated with workplace characteristics than employment itself. Time lived in the United States was a major factor associated with being uninsured for Mexican adults, while language barriers were a major factor limiting Puerto Rican individuals' access to private health insurance. The paper suggests two approaches for decreasing uninsurance among Latino adults: (1) strengthening the link between employment and private health insurance and (2) addressing disparities in access to public coverage for racial and ethnic groups, including recent immigrants.

Acculturation↗
PubMed2004

Are the additional health expenditures generated by insurance bad for society?

Conventional economic theory has concluded that the additional health expenditures generated by insurance coverage are bad for society and lead to inefficiently high health care expenditures. To reduce costs, economists have promoted solutions--cost sharing insurance policy and managed care--designed to reduce this additional care. This article discusses a new theory of insurance that suggests that much of these additional health expenditures are actually efficient and good for society. As a result, insurance coverage is much better for society than economists have thought. Also, the policy prescriptions are different. The new theory suggests that cost sharing should be applied sparingly, that policy should focus on reducing high prices in order to reduce health expenditures, and that the uninsured should be insured under some type of national insurance program.

Cost Sharing↗
PubMed2004

Why the United States has no national health insurance: stakeholder mobilization against the welfare state, 1945--1996.

The United States is the only western industrialized nation that fails to provide universal coverage and the only nation where health care for the majority of the population is financed by for-profit, minimally regulated private insurance companies. These arrangements leave one-sixth of the population uninsured at any given time, and they leave others at risk of losing insurance as a result of normal life course events. Political theorists of the welfare state usually attribute the failure of national health insurance in the United States to broader forces of American political development, but they ignore the distinctive character of the health care financing arrangements that do exist. Medical sociologists emphasize the way that physicians parlayed their professional expertise into legal, institutional, and economic power but not the way this power was asserted in the political arena. This paper proposes a theory of stakeholder mobilization as the primary obstacle to national health insurance. The evidence supports the argument that powerful stakeholder groups, first the American Medical Association, then organizations of insurance companies and employer groups, have been able to defeat every effort to enact national health insurance across an entire century because they had superior resources and an organizational structure that closely mirrored the federated arrangements of the American state. The exception occurred when the AFL-CIO, with its national leadership, state federations and union locals, mobilized on behalf of Medicare.

Health Benefit Plans, Employee↗
PubMed2005

Entrances and exits: health insurance churning, 1998-2000.

Analysis of 1998-2000 health insurance data from the Medical Expenditure Panel Survey shows large numbers of people with unstable health insurance coverage. Young adults, Hispanics, people with low levels of education, those who transition into and out of poverty, and those with private non-group insurance are most likely to have unstable coverage. In addition, demographic factors and type of insurance interact to determine stability of coverage. Young adults and Hispanics with Medicaid or private insurance, for example, were relatively likely to lose their coverage. And less than half of people who transitioned into and out of low income and were initially uninsured were able to obtain coverage. Policies must target these high-risk groups in order to provide them with stable health insurance coverage.

Adult↗
PubMed1989

[The responsibility for confidentiality--private insurance medicine information--data protection].

1. Professional discretion/insurance discretion and data privacy protection are dependent, they overlap and supplement. The insurance discretion has contractual foundations, which originate in the personal insurance's unique confidential relationship. Data privacy protection is conceptually based on the Federal Data Protection Law, signed on Jan. 27, 1977. Insurance discretion and data privacy protection are of the upmost universal personal rights protected under the constitution. 2. Violation of either the "doctor's duty of discretion" or the "personal insurance's duty of discretion" is punishable by law. 3. The regulations regarding the policy holder's violation of his duty to disclose substantial risks and their verification are supplemented by contractual stipulations calling for a release from the duty of professional discretion. 4. The data privacy protection clause, also a contractual stipulation, takes into account the "relativity of the personal domain" in view of the insurance companies' mass business and the particulars of the "community of risks". 5. Professional discretion/insurance discretion and data privacy protection have experienced a legally ensured and practical interpretation. However this does not exonerate the insurance medical doctors, especially in borderline cases, from reflecting with great care and according to standard legal principle on the observance of professional discretion.

Confidentiality↗
PubMed1982

[Mental health damages in social insurance].

Disablement Insurance As a rule there cannot be claimed medical measures for treatment of schizophrenia, cyclic and organic psychoses, neuroses, hypochondria and hysteria. A mental disturbance substantiates the claim for the disablement pension if due to its seriousness the utilization of the working capacities of the insured on the labour market cannot be demanded or if such a utilization is not bearable for the society. Compulsory Accident Insurance The Swiss Accident Insurance Organization is only liable for those neuroses that are in an adequate causality to the accidental occurrence it covers. Here belong the genuine accident neurosis, the fear neurosis and the therapy neurosis, however not the covetous neurosis. Health Insurance The insured afflicted with a neurosis cannot claim the sickness benefit as long as he is capable to overcome his reluctance to the assumption of sufficient work.

Disability Evaluation↗
PubMed1997

Changes in the 1995 Current Population Survey and estimates of health insurance coverage.

This analysis compares the March 1994 and March 1995 Current Population Survey (CPS) counts of the numbers of people with different types of health insurance and without any health insurance coverage. The findings contain some surprises: there were no changes in the numbers of nonelderly people with Medicaid coverage and without any health insurance, and there were increases in the numbers of nonelderly people with employer-sponsored health insurance and with CHAMPUS/VA/military health care. Four changes were introduced in the CPS in 1995 and were likely, by themselves, to both raise and lower the estimates of the numbers of people with specific types of health insurance coverage. Three of the changes relate to questions about health insurance coverage; they coincide with the traditional mid-decade shift in the sample framework for the CPS.

Adult↗
PubMed1997

Insurance underwriting in the genetic era.

Genetic technology is assuming a greater role in the practice of medicine. Insurers have a vested interest because individually underwritten insurance cannot be sold without risk classification, and much of the medical information needed to classify risks will have a genetic component. This paper reviews recent genetic advances and their potential impact on life, disability income, long-term care, and critical illness insurance. Alzheimer disease is chosen to illustrate the effect of an organized effort to withhold medical information from insurance companies. Consumers will not support a private insurance mechanism with extensive cross-subsidization among policyholders and where medical information becomes inviolate simply because it is genetic. A framework for deliberations with the medical community is proposed.

Alzheimer Disease↗
PubMedDate not supplied

Choice of health insurance by families of the mentally ill.

This paper investigates whether choice of health insurance is influenced by the perceived mental and physical health of family members among a sample of policy-holders with private health insurance. A multinomial probit model of the choice among major medical coverage only, traditional full coverage, and coverage through a health maintenance organization is estimated. Results indicate that the presence of at least one family member who rates his or her general health as poor does not affect the policy-holder's choice of health insurance. However, the presence of at least one family member considered at risk of mental illness does in some instances affect the policy-holder's choice of health insurance: We observe significant effects for policy-holders who are female, black, have some college education, work for a large firm, and live in an urban area. These findings suggest that adverse selection may arise when individuals are able to choose between health insurance policies with different degrees of coverage for mental health care and that such effects are far more pronounced for those people who consider themselves at risk for mental illness than physical illness.

Black or African American↗
PubMedDate not supplied

Health care policy evaluation using longitudinal insurance claims data: an application of the panel Tobit estimator.

The British Columbia Ministry of Health provides enhanced prescription drug insurance coverage to residents aged 65 and older. This exogenous change in the effective price of prescription drugs is used to investigate aspects of the drug use by seniors. Three sets of issues are of interest. First, what is the effect of enhanced insurance coverage on drug use and programme costs once drugs are provided free of charge? Second, is this effect permanent, or transitory? Third, are any increases in use observed concentrated among those with lower incomes? Longitudinal administrative claims payment data on 18,000 seniors over the period 1985-92 are used. All individuals in the sample turned 65 at some point and therefore became eligible for subsidized prescription drugs. Health status information is not collected; instead, health status is treated as an individual-specific fixed endowment, subject to a common rate of decay. Estimation is complicated by censoring of real drug expenditures for those under 65, rendering 'first differencing' methods invalid. A semi-parametric fixed effects Tobit estimator is used instead. For most individuals, the extension of insurance does not permanently increase drug use. Males with lower income were the exception. Little evidence of transitory effects to insurance coverage was found. Finally, the extension of insurance has made only a minor contribution to growth in seniors' drug use, relative to secular growth in drug use over time.

Age Factors↗
PubMed1982

Insurance, competition and cost containment.

Most economists have suggested that the growing presence of insurance, including Medicare, Medicaid, Blue Cross and the commercial insurers, is largely responsible for the rapid rise of health care costs in the United States. It is the contention of this paper, however, that the insurance industry in the private sector in the United States may help in the effort to contain costs rather than solely stimulating rapidly increasing costs. A number of methods that insurers have employed to contain costs, including monitoring provider behavior and prospective reimbursement, are identified. It is cautioned, however, that although health insurer cost containment efforts will continue to expand in the future, perversities in the U.S. tax laws, potential provider opposition and the complexities of medicine will continue to make cost containment a difficult task.

Cost Control↗
PubMed1985

Private health insurance of the Medicare population and the Baucus legislation.

The appropriateness of the benefits associated with the private insurance coverage of the Medicare population has been the subject of considerable concern. Section 507 of the Social Security Amendments of 1980, also known as the Baucus legislation, reflects public concerns about the level of benefits in relation to premiums, duplicative coverage, the complexity and difficulty of insurance terminology, and marketing abuses. Data from the National Medical Care Expenditure Survey can provide useful baseline data on the distribution of Baucus-like plans. In 1977, private insurance held by the Medicare population was more likely to cover inpatient than outpatient services and to emphasize "first dollar" benefits for long-term care. Multivariate analyses show that the distribution of Baucus-like insurance policies is highly associated with health status, source of insurance, region, and place of residence. The importance of state regulations, suggested in other research, may account for these patterns.

Aged↗
PubMed2005

Insurance in a climate of change.

Catastrophe insurance provides peace of mind and financial security. Climate change can have adverse impacts on insurance affordability and availability, potentially slowing the growth of the industry and shifting more of the burden to governments and individuals. Most forms of insurance are vulnerable, including property, liability, health, and life. It is incumbent on insurers, their regulators, and the policy community to develop a better grasp of the physical and business risks. Insurers are well positioned to participate in public-private initiatives to monitor loss trends, improve catastrophe modeling, address the causes of climate change, and prepare for and adapt to the impacts.

Climate↗
PubMed1979

The privacy implications of insurers' information practices.

Insurers and their support organizations are among the largest collectors and users of personally identifiable information in the United States, yet little attention has been focused historically on the implications of insurers' information practices to individuals' privacy. Moreover, these practices are virtually opaque from the subject individual's point of view--in other words, individuals do not realize the full implications to their privacy when they enter into relationships with insurers. Thus, individuals may be at a disadvantage from a privacy protection standpoint in dealing with insurers. This paper analyzes insurers' information practices from a privacy protection perspective and suggests several areas that need improvement.

Confidentiality↗
PubMed1981

Private health insurance plans in 1978 and 1979: a review of coverage, enrollment, and financial experience.

The private health insurance industry collected $55.9 billion in premiums in 1979 and returned $50.2 billion in benefits to its subscribers. Premiums rose 12.4 percent, slightly faster than in 1978 when premiums rose 11.4 percent, to $49.7 billion. Benefits rose 11.4 percent in 1979, down from the 12.6 rate in 1978. After operating expenses were deducted, the industry showed underwriting losses of $1.4 billion in 1979 and $1.5 billion in 1978. About 78 percent of the population was insured for hospital care, 76 percent for x-ray and laboratory examinations, and about 76 percent for surgical services in 1979. Smaller percentages had coverage for other types of care. An estimated 64 percent of the aged bought private hospital insurance, and about 43 percent bought surgical insurance, mostly to supplement Medicare benefits. An estimated 12 percent of persons under age 65 had no protection against the cost of hospital care either through private insurance or a public program such as Medicare or Medicaid.

Insurance↗
PubMed1997

Health insurance reform legislation.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA), enacted on August 21, 1996 (Public Law 104-19), provides for improved access and renewability with respect to employment-related group health plans, to health insurance coverage sold in connection with group plans, and to the individual market (by amending the Public Health Service Act). The Act's provisions include improvements in portability and continuity of health insurance coverage; combatting waste, fraud, and abuse in health insurance and health care delivery; promoting the use of medical savings accounts; improving access to long-term care services and insurance coverage; administrative simplification; and addressing duplication and coordination of Medicare benefits.

Career Mobility↗
PubMed1993

Will universal health insurance assure universal access to ongoing primary care for adults?

OBJECTIVE: To assess the impact of current public insurance status (Medicare and Medicaid) and hypothetical payment levels of a new insurance program on physician acceptance of adult primary care patients desiring continuing care. METHOD: Survey of 175 primary care physicians in a medium-sized city and six surrounding counties in North Carolina. MAIN OUTCOME MEASURE: Likelihood of accepting new continuing care patients covered by Medicare, Medicaid, or a hypothetical health insurance system mandated to cover the uninsured. RESULTS: The response rate was 80%; 86% of the respondents were accepting new patients with private insurance. Of the remaining physicians, 72% were not accepting new continuing care patients covered by Medicaid and 55% were not accepting patients who paid via Medicare assignment alone. Seventy-nine percent of respondents were unlikely to accept new continuing care patients insured by a hypothetical public plan that reimbursed physicians at 60% of reimbursement levels provided by privately insured patients, compared with only 25% who were unlikely to accept patients if the reimbursement was 80% of the private level. CONCLUSIONS: Medicaid and Medicare do not assure access to continuing primary care. Also, physician reimbursement is an important determinant in any new health care system designed to provide universal and consistent access to regular primary care services.

Adult↗
PubMed1993

Insurance coverage and residents' experience in a pediatric teaching clinic.

To examine the relationship between insurance coverage and the diagnostic content of residents' experience in a hospital-based pediatric teaching clinic, we analyzed outpatient problem lists for 6543 patients seen in our clinic over a 15-month period. Problem-list contents were categorized using diagnostic clusters. The frequency distribution of clustered problems was compared for patients with four types of insurance coverage: indemnity insurance, health maintenance organization, Medicaid, and no insurance. The four insurance categories differed in the overall distribution of problems, but the differences could not be attributed to a disparity in the frequency of any single diagnosis or diagnostic cluster. We conclude that there was no important effect of insurance coverage on the diagnostic content of residents' experience in a teaching clinic.

Child↗