Health Care in Hawai'i: An Agenda for Research and Reform

2000 ◽  
Vol 26 (2-3) ◽  
pp. 205-223
Author(s):  
Sylvia A. Law
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Community Health Centers ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Census Bureau ◽  
United States Census ◽  
United States Census Bureau ◽  
The People

In 1999, the United States Census Bureau reported that 16.3% of Americans did not have health insurance in 1998, up from 16.1% in 1997 and 13% in 1990. The increased lack of health insurance is particularly troubling because the unemployment rate is down and the economy is vibrant. The Census Bureau also reported that Hawafi led the Nation in providing health insurance, with only 8.8% of the population uninsured. This fact alone makes Hawai'i a model for the U.S. Hawaii's success goes beyond providing health insurance coverage. “Coverage is not care.” The state is also a model in terms of providing care through community health centers. Broad insurance coverage, and access to care through community based primary care centers, help to make the people of Hawai'i healthy. Further, Hawai'i's health care costs are lower than costs in the rest of the nation.

scholarly journals Problems of health insurance coverage and health care in the United States: public and private solution strategies

1992 ◽  
Vol 8 (3) ◽  
pp. 270-286
Author(s):  
E. Richard Brown
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Care Financing ◽  
Health Insurance Coverage ◽  
The United States ◽  
Political Debate ◽  
Financing System

A nearly universal consensus has developed in the United States that the current health care financing system is a failure. The system has been unable to control the continuing rapid rise in health care costs (by far, the highest in the world), and it has been unable to stem the growing population that has no health insurance coverage (at least 36 million people). There is nearly universal political agreement that government must provide health insurance to a far greater share of the population than ever before. The political debate now focuses on whether this expanded government role should supplement the private insurance system with an enlarged public program covering those left out of private insurance coverage, or replace private insurance with a universal government health insurance program covering the entire population.

Racial Differences in Health Insurance Coverage and Medical Expenditures in the United States

2006 ◽  
Vol 30 (4) ◽  
pp. 529-550 ◽  
Author(s):  
Melissa A. Thomasson
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Racial Differences ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Medical Expenditures ◽  
Health Care Spending ◽  
Data Set ◽  
Racial Gap

This article uses a unique data set from 1957 to examine the racial gap in health insurance coverage and the extent to which that gap influenced racial differences in health care spending. Results indicate that black households in 1957 were statistically significantly less likely to purchase health insurance than white households, even after controlling for differences in income, years of schooling, age, family size, marital status, and other personal and job-related characteristics. Findings in the article also provide weak support for the hypothesis that a racial gap in health insurance coverage contributed to racial differences in health care spending between blacks and whites; even after controlling for differences in income, education, and other characteristics, racial differences in medical expenditures were smaller for insured than for uninsured families, although the result is not statistically significant.

The Changing Health Insurance Coverage Landscape in the United States

2020 ◽  
pp. e264-e274
Author(s):  
K. Robin Yabroff ◽  
Samuel Valdez ◽  
Mireille Jacobson ◽  
Xuesong Han ◽  
A. Mark Fendrick
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Cancer Care ◽  
Care Delivery ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Future Research ◽  
Health Coverage

Changes in the health insurance coverage landscape in the United States during the past decade have important implications for receipt and affordability of cancer care. In this paper, we summarize evidence for the association between health insurance coverage and cancer prevention and treatment. We then discuss ongoing changes in health care coverage, including implementation of provisions of the Affordable Care Act, increasing prevalence of high-deductible health insurance plans, and factors that affect health care delivery, with a focus on vertical integration of hospitals and providers. We summarize the evidence for the effects of the changes in health coverage on care and discuss areas for future research with the goal of informing efforts to improve cancer care delivery and outcomes in the United States.

PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Factors Affecting ◽  
The People ◽  
Universal Health Insurance Coverage ◽  
The Social

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

Data Processing Improvements for Estimates of Health Insurance Coverage in the Current Population Survey Annual Social and Economic Supplement

2021 ◽  
pp. 107755872110008
Author(s):  
Edward R. Berchick ◽  
Heide Jackson
Keyword(s):  
Health Insurance ◽  
Data Processing ◽  
Current Population Survey ◽  
Population Survey ◽  
Insurance Coverage ◽  
Processing System ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Insurance Data ◽  
Current Population

Estimates of health insurance coverage in the United States rely on household-based surveys, and these surveys seek to improve data quality amid a changing health insurance landscape. We examine postcollection processing improvements to health insurance data in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), one of the leading sources of coverage estimates. The implementation of updated data extraction and imputation procedures in the CPS ASEC marks the second stage of a two-stage improvement and the beginning of a new time series for health insurance estimates. To evaluate these changes, we compared estimates from two files that introduce the updated processing system with two files that use the legacy system. We find that updates resulted in higher rates of health insurance coverage and lower rates of dual coverage, among other differences. These results indicate that the updated data processing improves coverage estimates and addresses previously noted limitations of the CPS ASEC.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

scholarly journals Rurality of Residence and Inappropriate Antibiotic Use for ARI Among Young Tennessee Children

2020 ◽  
Author(s):  
Keerti L Dantuluri ◽  
Jean Bruce ◽  
Kathryn M Edwards ◽  
Ritu Banerjee ◽  
Hannah Griffith ◽  
...  
Keyword(s):  
Incidence Rate Ratio ◽  
Respiratory Infections ◽  
Antibiotic Use ◽  
The United States ◽  
Census Bureau ◽  
Outpatient Setting ◽  
United States Census ◽  
United States Census Bureau ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background Antibiotic use is common for acute respiratory infections (ARI) in children, but much of this use is inappropriate. Few studies have examined whether rurality of residence is associated with inappropriate antibiotic use. We examined whether rates of ARI-related inappropriate antibiotic use among children vary by rurality of residence. Methods We conducted a retrospective cohort study of children aged 2 months – 5 years enrolled in Tennessee Medicaid between 2007 and 2017 and diagnosed with ARI in the outpatient setting. Study outcomes included ARI, ARI-related antibiotic use, and ARI-related inappropriate antibiotic use. Multivariable Poisson regression was used to measure associations between rurality of residence, defined by the United States Census Bureau, and the rate of study outcomes, while accounting for other factors including demographics and underling comorbidities. Results 805,332 children met selection criteria and contributed 1,840,048 person-years (p-y) of observation. Children residing in completely rural, mostly rural, and mostly urban counties contributed 70,369 (4%) p-y, 479,121 (26%) p-y, and 1,290,558 p-y (70%), respectively. Compared with children in mostly urban counties (238 per 1000 p-y), children in mostly rural (450 per 1000 p-y) and completely rural counties (468 per 1000 p-y) had higher rates of inappropriate antibiotic use (adjusted incidence rate ratio [aIRR]: 1.34 (95% confidence interval [CI]: 1.33 – 1.35) and aIRR: 1.33 (CI: 1.32 – 1.35), respectively). Conclusion Inappropriate antibiotic use is common among young children with ARI, with higher rates in rural compared to urban counties. These differences should inform targeted outpatient antibiotic stewardship efforts.

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