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At least 19 recordsLinked to original sources
PubMed1995

No insurance, public insurance, and private insurance: do these options contribute to differences in general health?

This paper examines the validity of two of the basic assumptions made about health care insurance and health, namely that having any insurance is associated with better health and, in particular, that having public, welfare-based insurance has better health consequences for the poor than does having no insurance. These questions were addressed using data from the National Medical Expenditure Survey, a national household-based survey in 1987 of more than 36,000 people who were asked to report in detail about their medical care use and expenditures, health insurance coverage, and health and functional status. The results of the analysis indicate that being without insurance is associated with having poorer general health compared to persons with private insurance, and that the health of persons who qualify for public insurance is the poorest of any group--poorer even than those without insurance.

Adolescent↗
PubMed2004

Is it really worse to have public health insurance than to have no insurance at all? Health insurance and adult health in the United States.

Using prospective cohort data from the 1979 National Longitudinal Survey of Youth, this study examines the extent to which health insurance coverage and the source of that coverage affect adult health. While previous research has shown that privately insured nonelderly individuals enjoy better health outcomes than their uninsured counterparts, the same relationship does not hold for those publicly insured through programs such as Medicaid. Because it is unclear whether this finding reflects a true causal relationship or is in fact due to selection bias on socioeconomic status and health, previous estimates of the contribution of health insurance to inequities in health may have been biased. This study attempts to disentangle these competing hypotheses of causation or selection bias by using fixed effects models with sibling clusters to corroborate--or contradict--the results of a conventional OLS regression. By controlling for unobserved factors shared by siblings, such as parental genetic influences, sibling models estimate health insurance effects that are less affected by selection bias. Findings suggest that, among the US. birth cohorts of 1957 to 1961, the negative relationship between public health insurance and health is not causal, but rather due to prior health and socioeconomic status. Conversely, the lack of health insurance coverage has a strong cumulative negative impact on adult health.

Adult↗
PubMed1990

[Epidemiologic study of persons having group 2 insurance in Denmark. 3. A questionnaire study. Attitudes and knowledge of persons insured in group 2 concerning their insurance].

A questionnaire investigation among established persons insured in Group 2 and persons who have recently been transferred from Group 1 to Group 2 or vice versa shows that all three groups find that there are considerable advantages in insurance in Group 2. In particular, the right to free choice of general practitioner is emphasized. Under the present arrangement this is associated with geographic and temporal restrictions. In addition, it is regarded as an advantage to be able to change one's doctor (including specialist) from time to time. Approximately 1/3 emphasize that their way through the health system is easier in Group 2 and that they are treated more kindly. The reason for changing from Group 2 to Group 1 was mainly of economical nature. Where a number of persons were concerned, this was associated with retiral. Information about the health of this group also suggest that deterioration in health may also play a part in their choice. Nevertheless, the advantages of Group 2 insurance were not contested. The results of a series of investigations suggest that new Group 2 insured persons are considerably different from the established members of this group. This group consists mainly of young women. The transfer to insurance Group 2 was motivated mainly by definite dissatisfaction and where a number of these were concerned the change was merely temporary. It is concluded that the Group 2 form of health insurance has assumed new perspectives and forms of employment.

Adolescent↗
PubMed1994

Dental malpractice liability insurance market: surveys of insurers and insurance commissioners.

Surveys of malpractice insurers and state insurance commissioners in 1992 show a highly concentrated market with opportunities for greater competition. Fewer than 50 firms write coverage nationally. Weighted premiums for $1 million/$3 million coverage vary across U.S. census divisions from $1,700 in the South to $3,000 in the Northeast. These data may be of interest to practitioners who purchase insurance and will aid dental associations in effectively participating in revisions of malpractice liability statutes as part of overall health care reform.

Data Collection↗
PubMed1999

[Subjective health, need for rehabilitation and utilization in a West-East comparison--results of a survey of insured clients of the federal insurance office for employees and the Saxony federal insurance office].

There were substantial changes within the rehabilitation framework due to new laws as well as internal need for more flexibility. In connection with this process, the BfA and the LVA Sachsen initiated a survey among their insured persons, the main points being the need for and use of rehabilitative care. The results of a West/East comparison are presented. A questionnaire was send to approximately 29,000 insured persons, the overall response rate was 43%. White collar workers in the East reported a better state of health compared with those in the West, with the most profound differences found in females. Subjective health status and subjective working capability were highly associated. The proportion of persons who reported a need for rehabilitation amounts to 24% among the insured with the LVA Sachsen (blue collar workers, East) and 12% among the white collar workers in the East. Independent of the state of health there was also an association between work stress and the need for rehabilitation. Persons from the East were less informed about rehabilitative care than persons from the West. Financial and workplace problems were among the major reasons not to apply for a rehabilitation measure even if there is a need. These reasons were mentioned more often in the East. In conclusion, there are substantial differences between West and East concerning the rehabilitative health sector. A prominent role is played by the employment situation.

Adult↗
PubMed2000

Uninsured and unstably insured: the importance of continuous insurance coverage.

OBJECTIVE: To examine the importance of continuous health insurance for access to care by comparing the access and cost experiences of insured adults with a recent time uninsured to the experiences of currently uninsured adults and experiences of adults with no time uninsured within a reference time period (continuously insured). DATA SOURCES: Adults ages 18-64. Data draw from three different survey databases: the Robert Wood Johnson Foundation 1996-1997 Community Tracking Survey, the Kaiser/Commonwealth 1997 National Survey of Health Insurance, and the 1995-1997 Kaiser/Commonwealth State Low Income Surveys. STUDY DESIGN: The study groups individuals into three insurance categories based on respondents' reports of insurance coverage within a reference time period: continuously insured; insured when surveyed but with recent time uninsured; and currently uninsured. In the two Kaiser/Commonwealth surveys the recently uninsured group included any insured respondent with a time uninsured in the past two years. In the Community Tracking Survey, the recently uninsured group included any insured respondent with a time uninsured in the past year. Measures of access include foregoing health care when needed, usual source of care, use of health care services, difficulties paying for medical care, and satisfaction with care. DATA COLLECTION: All three surveys were conducted primarily by telephone. The Community Tracking Survey drew from 60 community sites, with an additional random national sample. The Kaiser/Commonwealth National Survey was a random national sample; the Kaiser/Commonwealth State Low Income Surveys included adults ages 18-64 with incomes at or below 250 percent of poverty in seven states: Minnesota, Oregon, Tennessee, Florida, Texas, New York, and California. PRINCIPAL FINDINGS: Compared to the continuously insured, those insured but with a recent time uninsured were at high risk of going without needed care and of having problems paying medical bills. This group was two to three times as likely as those with continuous coverage to report access problems. Rates of access and cost problems reported by insured adults with a recent time uninsured neared levels reported by those who were uninsured at the time of the survey. These two groups also rated care received more negatively than did adults with continuous insurance coverage. In general, the access gap between persons insured and uninsured widened as a result of distinguishing insured adults with a recent time uninsured from insured adults with no time uninsured. CONCLUSION: Studies that focus on current insurance status alone will underestimate the extent to which having a time uninsured during the year contributes to access difficulties and undermines quality of care, and will underestimate the proportion of the population at risk because they are uninsured. Policy reforms are needed to maintain continuous insurance coverage and avoid spells uninsured. Currently uninsured and unstably insured adults are both at high risk.

Adolescent↗