A Review of Data on the Health Sector of the United States

Hellander, Ida

doi:10.2190/0alw-410b-72xj-x25g

Cited by 4 publications

(7 citation statements)

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“…HMOs to achieve savings became especially salient as the number of HMOs increased in the mid-1980s, resulting in more competition among HMOs and higher turnovers among HMO enrollees (Hellander 2001;Wholey et al 1997). The growth of for-profit HMOs in the 1990s (Gabel 1997) and, more recently, the diversification of HMOs' products in response to consumer backlash and legislative pressure over restrictive care (Draper et al 2002) further exacerbate the concern.…”

mentioning

confidence: 99%

The Effects of HMO Penetration on Preventable Hospitalizations

Zhan¹,

Miller²,

Wong³

et al. 2004

Health Services Research

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confidence: 99%

The Effects of HMO Penetration on Preventable Hospitalizations

Zhan¹,

Miller²,

Wong³

et al. 2004

Health Services Research

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“…Those without insurance make fewer healthcare visits in the United States, more often receiving their health care in Mexico. 14 Lack of insurance adversely affects access to primary care and preventive services [15][16][17][18][19][20][21][22][23][24] as well as hospital care and rehabilitation services, [25][26][27] and although considerable attention has been paid to uninsured children and younger adults, little information has been published about the uninsured elderly. Even though the percentage of elderly without health insurance is small, their need for health care is substantially greater, and their numbers are increasing rapidly.…”

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confidence: 99%

Who Are the Uninsured Elderly in the United States?

Mold

Fryer

Thomas

2004

J American Geriatrics Society

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Because of the Medicare program, a common assumption is made that virtually all older Americans have health insurance coverage. Data from the 2000 National Health Interview Survey were analyzed to estimate the number of people aged 65 and older without health insurance; their stated reasons for being uninsured; and the associations between lack of insurance and sociodemographic variables, health status, and access to and use of healthcare services. In 2000, there were approximately 350,000 older Americans with no health insurance. Those without insurance were more likely to be younger, Hispanic, nonwhite, unmarried (widowed, divorced, or never married), poor, and foreign-born. They were less likely to hold U.S. citizenship. Despite relatively high rates of chronic medical conditions, they were unlikely to receive outpatient or home healthcare services. The most common reason given for lack of insurance was its cost. This study reveals important gaps in the availability of health insurance for the elderly, gaps that are likely to affect an increasing number of older Americans in the coming decade.

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“…1,2 The escalating cost of health insurance, medical care, and medications makes it increasingly difficult to find affordable solutions for broadening insurance coverage. 3,4 …”

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confidence: 99%

Insurance benefit preferences of the low-income uninsured

Danis¹,

Biddle

Goold

2002

J Gen Intern Med

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OBJECTIVE: A frequently cited obstacle to universal insurance is the lack of consensus about what benefits to offer in an affordable insurance package. This study was conducted to assess the feasibility of providing uninsured patients the opportunity to define their own benefit package within cost constraints. DESIGN: Structured group exercises SETTING: Community setting PARTICIPANTS: Uninsured individuals recruited from clinical and community settings in central North Carolina. MEASUREMENTS: Insurance choices were measured using a simulation exercise, CHAT (Choosing Healthplans All Together). Participants designed managed care plans, individually and as groups, by selecting from 15 service categories having varied levels of restriction (e.g., formulary, copayments) within the constraints of a fixed monthly premium comparable to the typical per member/per month managed care premium paid by U.S. employers. MAIN RESULTS: Two hundred thirty‐four individuals who were predominantly male (70%), African American (55%), and socioeconomically disadvantaged (53% earned <$15,000 annually) participated in 22 groups and were able to design health benefit packages individually and in groups. All 22 groups chose to cover hospitalization, pharmacy, dental, and specialty care, and 21 groups chose primary care and mental health. Although individuals' choices differed from their groups' selections, 86% of participants were willing to abide by group choices. CONCLUSIONS: Groups of low‐income uninsured individuals are able to identify acceptable benefit packages that are comparable in cost but differ in benefit design from managed care contracts offered to many U.S. employees today.

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A Review of Data on the Health Sector of the United States

Cited by 4 publications

References 0 publications

The Effects of HMO Penetration on Preventable Hospitalizations

The Effects of HMO Penetration on Preventable Hospitalizations

Who Are the Uninsured Elderly in the United States?

Insurance benefit preferences of the low-income uninsured

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