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PubMed1979

Rationales for public health insurance coverage of geriatric day care: issues, options, and impacts.

America's long-term care system has been widely criticized for many shortcomings. It relies too heavily upon institutional services, it is too costly, it forces inappropriate levels of care upon patients by offering too few options, in too many instances it offers inferior quality care, and it places too much emphasis on caring for physical ills without concern for enhancing patients' quality of life. Alternative modes and settings now under consideration could solve one or more of these problems, but the choices would be constrained by financial and technical barriers. Different choices have profoundly different consequences for costs and numbers and types of patients served. This paper considers different roles and their consequences for one alternative: geriatric day care. The issues raised apply to other alternatives.

Aged↗
PubMed1991

[The effect of sharing medical costs for the aged 70 or more on the financial balance of the health insurance society].

The rapid increase of the proportion of older persons in society has made the problem of medical costs more important. Although medical cost-sharing for those aged 70 or more is decided by their medical costs and by the current proportion of such persons in the Society, it is not constant throughout the Society. The study evaluated the contribution ratio of medical cost-sharing for those aged 70 or more to the financial balance of the Society. In addition, characteristics of the Society associated with medical cost-sharing for those aged 70 or more were analyzed. The results are as follows. 1) Medical cost-sharing for those aged 70 or more was the greatest factor in the financial balance of the Society with a contribution ratio of as much as 55.2%. 2) Multiple regression analysis disclosed that dependent ratio, the average monthly salary, the area, the rate of those aged 70 or more and the average age of the Society members are significant in medical cost-sharing for those aged 70 or more. 3) Dependent ratio and the average monthly salary are the most important characteristics among those associated with medical cost-sharing for those aged 70 or more. A higher dependent ratio and a lower average monthly salary are related to higher cost-sharing. This is also related to geographic factors as cost-sharing in western Japan is higher than in eastern Japan. The lower rate of those aged 70 or more and the higher average age of the Society members are related to the higher cost-sharing.

Aged↗
PubMed2005

The impact of states' small group health insurance reforms on uninsurance rates.

The impact of states' small group market reforms on uninsurance rates was examined. Reform status was quantified on five reform dimensions: Access Improvement, Premium Reduction, Premium Differential Reduction, Continuity of Coverage, and Enhancing Valued Plan Features. These reform indices were calculated based on actuarial judgment of the market impact potential of each regulation. Regression analysis showed no association between uninsurance rates and the depth of reforms on any dimension, while controlling for income, foreign-born population, black population, and employment in the smallest businesses. Possible reasons for the lack of impact are discussed.

Government Regulation↗
PubMedDate not supplied

Changes in health insurance coverage during the economic downturn: 2000-2002.

Using Current Population Survey data from 2000-2002, this paper documents the changes that led the uninsured population to grow by 3.8 million during that time period. All of the increase in the uninsured occurred among adults, and two-thirds was among low-income adults. The extent to which the loss of employer coverage resulted in people becoming uninsured depended on their access to public programs: Children were more likely than adults to gain public coverage; women more likely than men; and parents more likely than nonparents. Middle- and higher-income Americans were also affected because many lost income and because rates of employer coverage were lower.

Adult↗