The Impact of Income on Healthcare Options Essay

This study investigates the impact of income on the types of healthcare options available to individuals. Income inequality is growing with the exodus of manufacturing jobs from the country and an increase in low-paying jobs, part-time jobs and contract positions that usually lack health benefits (Shi, Starfield, Kennedy and Kawachi, 1999). In the absence of social policy that addresses income inequality, the promotion of primary care may serve as a palliative strategy for reducing the adverse effect of social inequality (Shi, Starfield, Kennedy and Kawachi, 1999).The Impact of Income on Healthcare Options Essay Even among higher-income adults, lack of health care insurance was associated with significantly decreased use of recommended health care services; increased income did not attenuate the difference in use between uninsured and insured adults (Ross, Bradley, Busch, 2006). Efforts to improve the use of recommended health care services among uninsured should focus on patient education and expanding insurance eligibility for both lower-income and higher income adults (Ross, Bradley, Busch, 2006).The Impact of Income on Healthcare Options Essay

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Medicaid and Medicare coverage, encompassing nearly one-third of persons with disabilities may also represent an employment barrier in many cases because the potential loss of such coverage can be an important disincentive to taking a job (Kruse, 1993). For example, due largely to lower employment rates, persons with disabilities have lower average household and personal incomes and are more likely to be living in poverty and receiving means-tested income than are persons without disabilities (Kruse, 1993). Also, while the rate of health insurance coverage is similar for the two populations, persons with disabilities are more likely to receive coverage from Medicare or Med The Impact of Income on Healthcare Options Essay

This study investigates the impact of income on the types of healthcare options available to individuals. Income inequality is growing with the exodus of manufacturing jobs from the country and an increase in low-paying jobs, part-time jobs and contract positions that usually lack health benefits (Shi, Starfield, Kennedy and Kawachi, 1999). In the absence of social policy that addresses income inequality, the promotion of primary care may serve as a palliative strategy for reducing the adverse effect of social inequality (Shi, Starfield, Kennedy and Kawachi, 1999). Even among higher-income adults, lack of health care insurance was associated with significantly decreased use of recommended health care services; increased income  The Impact of Income on Healthcare Options Essay
One in five US citizens are struggling to cope with medical debts and an ‘alarming high’ proportion of adults with chronic illness regularly skip their medication because they can’t afford it, according to a new study conducted by the Commonwealth Fund (Royal Society for the Promotion of Health, 1996). The study, which surveyed 4,350 adults across the country, also found that two out of five uninsured adults who reported debt were unable to pay for basic necessities like food, heat or rent because of mounting medical bills (Royal Society for the Promotion of Health, 1996). The uninsured are more likely to go without preventative care or screening tests that could prevent more serious and costly health problems (Royal Society for the Promotion of Health, 1996). For an uninsured person who is unlucky enough to get sick, it is easy to see how quickly they can fall into a downward spiral of debt, forgone care and poorer health (Royal Society for the Promotion of Health, 1996). Individual income impacts health status, but it is confounded by variables such as education and social capital. Social capital theory describes social relationships and their impact on health. Income distribution, the gap between the wealthiest and poorest, also affects health (Sistrom, Hale, 2006). There are 45 million Americans without health insurance and their ranks are growing by 1 million a year (Shapiro, 1999).  The Impact of Income on Healthcare Options Essay

The United States per capita health care spending is the highest in the world. This dissertation addresses the impact of additional health care spending/medical service usage on health status. First two chapters investigate the role of insurance on medical service use in understudied dental market. The third chapter examines the effectiveness of additional health care spending on infant health outcomes.The Impact of Income on Healthcare Options Essay

The first chapter estimates the causal relationship between adult Medicaid dental benefits and dental service usage for low-income adults by using difference-in-differences technique exploiting the state-level variation in adult Medicaid dental benefit. The results suggest that adult Medicaid dental benefit increases the possibility of dental visit by 16.4 – 22 percent. The evidence that the increased dental service use improves dental health among low-income people is also presented. The second chapter investigates the relationship between dental insurance and dental service use among older populations. Between ages of 61 and 68, 24 percent of people with at least high school diploma lose dental insurance. The decrease in dental coverage is primarily driven by the loss of employer provided dental benefit with retirement. Utilizing this rapid drop in the number of people with dental insurance at around age 65, I find that there is no evidence of a decrease in dental service usage among older populations.The Impact of Income on Healthcare Options Essay

The third chapter, which is co-authored with Marks, addresses the benefit of additional health care spending for newborns. We use the number of infants born on a given day in a given location as an identifying variable to generate exogenous variation in health care spending. Using detailed information on every hospital birth in California from 2002 to 2006, we find that hospital stays are less intensive when the hospitalization region is more crowded. The second stage analysis suggests that the additional health care spending on infants born on less crowded days does not improve infant health status measured by mortality rate and readmission rate.The Impact of Income on Healthcare Options Essay

More than 2 billion people live in developing countries with health systems
constrained by inequitable access and inadequate funding. The World Health
Organization estimates that more than 150 million of these people suffer financial
breakdown every year having to make unexpected out-of-pocket expenditures for
emergency care.
To improve health and reduce the financial burden on households, a number of
developing countries, including Ghana, Colombia, and Peru, have recently introduced
social health insurance programs which are heavily subsidized. The dissertation is a
collection of three essays looking at how individual health care choices changed as a
result of the availability of insurance coverage in Ghana.
The first essay evaluates health care choices and out-of-pocket expenditures
after the introduction of social health insurance covering modern health care services.
When ill, an individual decides between a set of alternatives; no care, alternative
(traditional) medicine, modern care and both alternative and modern care. My results
show that when health insurance becomes available, individuals either switch to modern
medical care or complement alternative care with modern care. I also find that out-of-
pocket expenditures decrease significantly across all the different types of care as a
result of health insurance.
The second essay studies the effect of health insurance on household fertility
decisions and examines whether the effect is due to women likely to become pregnant
seeking out insurance (adverse selection effect) or women with insurance changing
fertility decisions (moral hazard effect). To disentangle the effects of adverse selection
from moral hazard, I exploit district-level variation in the dates of implementation of the
national health insurance to instrument for insurance enrollment. My results suggest that
both adverse selection and moral hazard effects were present and fertility increased with
insurance.The Impact of Income on Healthcare Options Essay
The third essay examines the role of social health insurance on prenatal care and
expenditure using a two-part model. Results show that health insurance increases the
propensity of pregnant women to seek prenatal care relative to the uninsured. Insured
pregnant women are more likely to seek prenatal care, but conditional on any spending,
they spend less out-of-pocket compared to the uninsured. The Impact of Income on Healthcare Options Essay