How Much Health Insurance Is Enough? Revisiting the Concept of Underinsurance

@article{Blewett2006HowMH,
  title={How Much Health Insurance Is Enough? Revisiting the Concept of Underinsurance},
  author={Lynn A. Blewett and Andrew Ward and Timothy J Beebe},
  journal={Medical Care Research and Review},
  year={2006},
  volume={63},
  pages={663 - 700}
}
There is little consensus on what constitutes adequate health insurance coverage. The concept of a lack of adequate coverage, or underinsurance, is a matter of ongoing debate. A measure of adequate coverage is of critical importance as the nature of health insurance products evolves. Changes to health coverage include more direct out-of-pocket spending by consumers and a reduction of covered benefits. This article updates and extends an earlier review of underinsurance measurement published in… 

Figures from this paper

The Extent of Underinsurance: New Zealand Evidence

It has been a common assumption by the insurance industry world-wide that households are under-insured. We examine new evidence for underinsurance using a comprehensive survey of New Zealand

Underinsurance in the United States: an interaction of costs to consumers, benefit design, and access to care.

It is argued that the adequacy of health insurance coverage should also be assessed in terms of the inadequacy of specific benefits coverage and access to care.

Measuring Adequacy of Coverage for the Privately Insured

Variation in out-of-pocket spending over time and across states is shown, highlighting concern about the adequacy of coverage for 2.9% of privately insured children and 7.8% of private insured adults.

Underinsurance among children in the United States.

The number of under insured children exceeded the number of children without insurance for all or part of the year studied, and access to health care and the quality of health care are suboptimal for uninsured and underinsured children.

WHAT IS “ AFFORDABLE ” HEALTH CARE ? A review of concepts to guide policymakers

This joint Penn LDI and United States of Care issue brief considers affordability as an economic concept, as a kitchen-table budget issue for individuals and families, and as a threshold in current policy.

Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability

It is found that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage, and with depression, poor perceived health, or poverty.

What Is "Affordable" Health Care?

This joint Penn LDI and United States of Care issue brief considers affordability as an economic concept, as a kitchen-table budget issue for individuals and families, and as a threshold in current policy.

The evolution of medical spending risk.

  • J. GruberHelen Levy
  • Economics, Medicine
    The journal of economic perspectives : a journal of the American Economic Association
  • 2009
Evidence from Consumer Expenditure Survey microdata is presented on how the distribution of household spending on health -- that is, out-of-pocket payments for medical care plus the household's share of health insurance premiums -- has changed over time, and how much risk households should face from the perspective of economic efficiency.

Keeping up with the Cadillacs: What Health Insurance Disparities, Moral Hazard, and the Cadillac Tax Mean to The Patient Protection and Affordable Care Act.

  • R. Fletcher
  • Medicine, Political Science
    Medical anthropology quarterly
  • 2016
The proposed Cadillac tax on high-cost health plans will increase problems with appropriate health care access and medical financial burden for many families, as trends to reduce benefits and increase cost sharing reduce affordability and access.

How many are underinsured? Trends among U.S. adults, 2003 and 2007.

With health insurance moving toward greater patient cost sharing, this study finds a sharp increase in the number of underinsured people, and the need for policy attention to benefit design, to assure care and affordability.

References

SHOWING 1-10 OF 61 REFERENCES

Conceptualising the Lack of Health Insurance Coverage

It is argued that in terms of thenumbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment, and the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance.

Inadequate health insurance: costs and consequences.

Examining the experiences of insured adults as they try to get needed healthcare and balance the payment for these services against other basic needs finds substantial proportions of low- and modest-income, insured adults who struggle to afford insurance premiums find that their insurance plans do not provide either access to care when needed or financial protection from the cost of that care.

Paying medical bills in the United States. Why health insurance isn't enough.

Data is used from a recent national household survey of Americans to look directly, rather than at proxy measures, at who reports actual problems paying medical bills, and who they are.

Does Chronic Illness Affect the Adequacy of Health Insurance Coverage?

Using data from healthy and chronically ill individuals in Indiana, it is found that chronic illness decreased the probability of having adequate insurance coverage by about 10 percentage points among all individuals and by about 25% among single individuals.

Insured but not protected: how many adults are underinsured?

This study estimates that nearly sixteen million people ages 19-64 were underinsured in 2003, and underinsured adults were more likely to forgo needed care than those with more adequate coverage and had rates of financial stress similar to those of the uninsured.

Battery-powered health insurance? Stability in coverage of the uninsured.

Policymakers should think of "uninsured" as referring not to people, but rather to gaps in coverage over time, and reforms that stop short of universal coverage should be evaluated in terms of their likely effects on the continuity and stability of coverage.

New estimates of the underinsured younger than 65 years.

This estimate of the number of people who are underinsured for catastrophic illness is almost half again larger than the number that was widely cited during last year's debates on health system reform.

The American health care system. Health insurance coverage.

  • R. Kuttner
  • Political Science, Medicine
    The New England journal of medicine
  • 1999
The most prominent feature of American health insurance coverage is its slow erosion, even as the government seeks to plug the gaps in coverage through such new programs as Medicare+Choice, the

Trends in U.S. health insurance coverage, 2001-2003.

Expansion of public health insurance--including Medicaid and the State Children's Health Insurance Program (SCHIP)--forestalled a significant increase in the uninsured, as the proportion of the under-65 population enrolled in public coverage increased from 9 percent to 12 percent.

Defined-contribution health insurance products: development and prospects.

Defined-contribution health insurance products have received considerable recent attention, stimulated by double-digit increases in health plan premiums and employers' desire to get their employees
...