scholarly journals Delivering Public Health Insurance Through Private Plan Choice in the United States

2017 ◽  
Vol 31 (4) ◽  
pp. 3-22 ◽  
Author(s):  
Jonathan Gruber
Keyword(s):  
Public Health ◽  
United States ◽  
Health Insurance ◽  
Low Income ◽  
Private Insurance ◽  
The United States ◽  
Public Health Insurance ◽  
Market Failures ◽  
Wide Range ◽  
The Government

The United States has seen a sea change in the way that publicly financed health insurance coverage is provided to low-income, elderly, and disabled enrollees. When programs such as Medicare and Medicaid were introduced in the 1960s, the government directly reimbursed medical providers for the care that they provided, through a classic “single payer system.” Since the mid-1980s, however, there has been an evolution towards a model where the government subsidizes enrollees who choose among privately provided insurance options. In the United States, privatized delivery of public health insurance appears to be here to stay, with debates now focused on how much to expand its reach. Yet such privatized delivery raises a variety of thorny issues. Will choice among private insurance options lead to adverse selection and market failures in privatized insurance markets? Can individuals choose appropriately over a wide range of expensive and confusing plan options? Will a privatized approach deliver the promised increases in delivery efficiency claimed by advocates? What policy mechanisms have been used, or might be used, to address these issues? A growing literature in health economics has begun to make headway on these questions. In this essay, I discuss that literature and the lessons for both economics more generally and health care policymakers more specifically.

PERCENTAGE OF UNINSURED CHILDREN HAS INCREASED

PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 1051-1051
Author(s):  
STUDENT
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Low Income ◽  
Health Care Policy ◽  
The United States ◽  
Public Health Insurance ◽  
Care Policy ◽  
Low Income Families ◽  
Uninsured Children

The proportion of children in the United States without private or public health insurance increased from roughly 13 percent to 18 percent between 1977 and 1987, according to a new study by the Agency for Health Care Policy and Research (AHCPR). The growth in the proportion of uninsured children in poor and low-income families over the decade was even more dramatic—it rose from 21 percent to 31 percent.

Capitalizing on Illness: The Health Insurance Industry

1974 ◽  
Vol 4 (4) ◽  
pp. 583-598 ◽  
Author(s):  
Thomas Bodenheimer ◽  
Steven Cummings ◽  
Elizabeth Harding
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
Access To Health Care ◽  
Insurance Industry ◽  
Private Insurance ◽  
The United States ◽  
Insurance Companies ◽  
Health Insurance Industry

The private health insurance industry in the United States began as a money-collection mechanism for hospitals and doctors, and has evolved into an important profit-making sector of the economy. Blue Cross is dominated by hospital representatives and serves to channel money into the nation's hospitals. Physicians control Blue Shield and are its principal beneficiaries. And commercial insurance companies are closely linked to banks and industrial corporations through the country's large financial empires. Some effects of this elite control over the health insurance industry have been inadequate and distorted insurance coverage, discrimination against the elderly, the sick, and the poor, and rapidly rising medical costs. In addition, the control of Medicare and Medicaid by private insurance institutions has contributed to the enormous inflation produced by these programs. Though governments, consumers, and even the insurance industry itself are beginning to apply controls to the unprecedented medical inflation of the late 1960s, these controls tend to limit access to health care, especially for low-income people. Unless insurance companies are barred from the health care field and a public financing mechanism based on progressive taxation is introduced, health care will never be an equal right for everyone in the United States.

Voluntary Public Health Insurance for Low-Income Families: The Decision to Enroll

1995 ◽  
Vol 20 (4) ◽  
pp. 955-972 ◽  
Author(s):  
Carolyn W. Madden ◽  
Allen Cheadle ◽  
Paula Diehr ◽  
Diane P. Martin ◽  
Donald L. Patrick ◽  
...  
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Public Health Insurance ◽  
Low Income Families

scholarly journals Feeding the disparities: the geography and trends of breastfeeding in the United States

2018 ◽  
Author(s):  
Romain Garnier ◽  
Ana I. Bento ◽  
Pejman Rohani ◽  
Saad B. Omer ◽  
Shweta Bansal
Keyword(s):  
Public Health ◽  
United States ◽  
Breast Milk ◽  
Low Income ◽  
Temporal Trends ◽  
State Level ◽  
The United States ◽  
Poverty Level ◽  
Future Health ◽  
Breastfeeding Rates

AbstractThere is scientific consensus on the importance of breastfeeding for the present and future health of newborns, in high- and low-income settings alike. In the United States, improving breast milk access is a public health priority but analysis of secular trends are largely lacking. Here, we used data from the National Immunization Survey of the CDC, collected between 2003 and 2016, to illustrate the temporal trends and the spatial heterogeneity in breastfeeding. We also considered the effect sizes of two key determinants of breastfeeding rates. We show that, while access to breast milk both at birth and at 6 months old has steadily increased over the past decade, large spatial disparities still remain at the state level. We also find that, since 2009, the proportion of households below the poverty level has become the strongest predictor of breastfeeding rates. We argue that, because variations in breastfeeding rates are associated with socio-economic factors, public health policies advocating for breastfeeding are still needed in particular in underserved communities. This is key to reducing longer term health disparities in the U.S., and more generally in high-income countries.

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