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At least 19 recordsLinked to original sources
PubMed1989

A profile of the medically uninsured in Georgia.

The provision of health care to the growing number of persons uninsured against medical expenses affects Georgia doctors, hospitals, and state and local government at all levels. While much is known nationally about the uninsured, there are no good data about this group in Georgia. This study uses U.S. Census Bureau data to provide a demographic profile of Georgians who lack health insurance and to identify groups at particular risk for being uninsured. Approximately 950,000 (17.7%) of non-elderly Georgia residents are uninsured, compared to 37 million (17.6%) in the U.S. as a whole. As is true generally in the U.S., those in Georgia who are poor, young, non-white, and in families with a female head are at greatest risk. Of particular note are the poor in Georgia with incomes from 50% to 100% of the federal poverty level (55.2% uninsured). This population deserves the special attention of all involved in finding a solution to this problem.

Employment↗
PubMed1990

The medically uninsured: problems, policies, and politics.

The ranks of the medically uninsured have grown significantly in recent years, but no consensus on a policy solution has emerged. After summarizing the characteristics of the uninsured population, this paper reviews diverse policy responses and their troubled political prospects.

Federal Government↗
PubMed1990

Medically uninsured children in the United States: a challenge to public policy.

This article is an examination of the nature and extent of the problem presented by medically uninsured children in the United States. First, the characteristics of the uninsured population are explored with a description of how age, family income, and employment status disproportionately affect families with children. Second, the Medicaid program and its historically inadequate response to this growing problem of uninsured children is examined. Third, the relationship between insurance status and the health and development of children is discussed. Finally, recent public policy initiatives that have been enacted or proposed to address this inequity in the present health care system are reviewed with a recommendation to establish a "Universal Maternal and Child Health Program."

Adolescent↗
PubMed1990

Medically uninsured children in the United States: a challenge to public policy.

This article is an examination of the nature and extent of the problem presented by medically uninsured children in the United States. First, the characteristics of the uninsured population are explored with a description of how age, family income, and employment status disproportionately affect families with children. Second, the Medicaid program and its historically inadequate response to this growing problem of uninsured children is examined. Third, the relationship between insurance status and the health and development of children is discussed. Finally, recent public policy initiatives that have been enacted or proposed to address this inequity in the present health care system are reviewed with a recommendation to establish a "Universal Maternal and Child Health Program."

Adolescent↗
PubMed1991

Politics and equity in policy-making for the medically uninsured.

A sizable number of Americans (many of low income) lack health insurance, and their ranks grew over the 1980s. One might expect to find vigorous political efforts to redress this inequity. In fact, conflicting normative and practical images of equity have blunted the sense of urgency of the problem, inhibited agreement on the proper division of labor between the market and government, and blocked consensus on strategic models for public policy for the uninsured.

Health Policy↗
PubMed1987

National policy and the medically uninsured.

Although the marketplace discipline imposed on the health care sector appears to be restraining increases in the cost of care, this haphazard and incremental "policy" is having deleterious effects on access to care by the uninsured. To help alleviate this problem within our current price-centered system, I suggest that three options be pursued: create state pools to fund indigent care; broaden insurance coverage availability through the workplace; and create medical individual retirement accounts to pay for long-term care, which would free up more funds for indigent care. We must mold our future health care system during this era of rapid change by developing a coherent policy, with input from both the private and the government sectors, to create an efficient and high-quality system that will provide needed care to all members of society.

Adolescent↗
PubMed1992

Private insurance reform in the 1990s: can it solve the health care crisis?

A number of health insurance reform proposals have surfaced at the state governmental level in the United States. These include Medicaid expansion for the below-poverty or near-poverty uninsured, state subsidy to individuals and/or businesses for the purchases of health insurance, risk pools for the medically uninsurable, insurance industry-initiated reforms within the small group market, the promotion of "stripped down" insurance plans that reduce premium cost, and state mandating of employer-sponsored health insurance for the employed uninsured. All of these insurance reform proposals have serious limitations: (1) they fail to address the inequities of the underwriting principle by which older and sicker people pay more for health insurance than the young and healthy population; (2) they extend the illogical linkage of employment and health insurance; and (3) they do not slow the rate of health cost inflation nor do they contain a mechanism to finance broader health coverage through savings within the health sector. An alternative to insurance reform is the establishment of a social insurance program that brings the entire population into a single risk pool.

Adult↗
PubMed1989

Cost effectiveness of current approaches to the control of retinopathy in type I diabetics.

Diabetic retinopathy is a leading cause of blindness among working age Americans. The epidemiology of diabetic eye disease has been well described in population-based studies and the effects of laser treatment have been tested in randomized controlled trials. The authors have designed a computer simulation model using the published reports of these studies to predict the medical and economic effects of applying currently accepted methods for the control of diabetic retinopathy to the population of type I diabetics. Recommendations for screening are taken from the Public Health Committee of the American Academy of Ophthalmology. Treatment recommendations and treatment efficacy are drawn from the reports of the Diabetic Retinopathy Study (DRS) and the Early Treatment Diabetic Retinopathy Study (ETDRS). Costs of screening and treatment are drawn from published Medicare reimbursement data. Over a 60-year period, the model predicts that proliferative diabetic retinopathy (PDR) requiring panretinal photocoagulation (PRP) will eventually develop in 72% of type I diabetics and macular edema will develop in 42%. If these treatments are delivered as recommended in the clinical trials, the model predicts a cost of $966 per person-year of vision saved from proliferative retinopathy and $1118 per person-year of central acuity saved from macular edema. This is only one seventh of the $6900 average cost of 1 year of Social Security Disability for those disabled by vision loss. Therefore, this model supports the use of federally funded eye care to prevent blindness in medically uninsured diabetics.

Adolescent↗
PubMed1991

Differences in hospital resource allocation among sick newborns according to insurance coverage.

OBJECTIVE: To assess whether newborns' insurance coverage was associated with differences in the allocation of hospital services. DESIGN: Retrospective analysis of computerized hospital discharge data, comparing resource allocation among newborns according to insurance status, controlling for race/ethnicity, diagnoses, hospital characteristics (ownership, teaching status, nursery level), and disposition. SETTING: All California civilian acute-care hospitals. PATIENTS: Population-based sample, excluding out-of-hospital and military hospital births. Resource allocation was studied among all newborns discharged in 1987 with evidence of serious problems (N = 29,751). MAIN OUTCOME MEASURES: Length of stay, total charges, and charges per day. RESULTS: Sick newborns without insurance received fewer inpatient services than comparable privately insured newborns with either indemnity or prepaid coverage. This pattern was observed across all hospital ownership types. Mean stay was 15.7 days for all privately insured newborns (15.6 days for those with indemnity and 15.7 days for those with prepaid coverage), 14.8 days for Medicaid-covered newborns, and 13.2 days for uninsured newborns (P less than .001). Length of stay, total charges, and charges per day were 16%, 28%, and 10% less, respectively, for the uninsured than for all privately insured newborns (P less than .001). Resources for newborns covered by Medicaid were generally greater than for the uninsured and less than for the privately insured. Both uninsured and Medicaid-covered newborns were found to have more severe medical problems than the privately insured. CONCLUSIONS: The findings cannot be explained by differences in medical need or by differences in non-medically indicated services; they constitute prima facie evidence of inequities that need to be addressed by policy changes.

California↗