Pourat N, Kominski G; Association for Health Services Research. Meeting.
Abstr Book Assoc Health Serv Res Meet. 1997; 14: 46-7.
UCLA Center for Health Policy Research, Los Angeles, CA 90095, USA.
RESEARCH OBJECTIVE(S): To study the employment and demographic predictors of private health insurance among the dependents of the employed, self-employed, and the unemployed. STUDY DESIGN: Using the 1987 National Medical Expenditure Survey, employment and demographic characteristics were used to predict private coverage for the population 0-64 years of age. We assigned work-related characteristics of working parents to unemployed spouses and children within the family unit and excluded those who had Medicare, Medicaid, or other public health care coverage. Logistic regression models were used to predict the probability of private insurance coverage versus being uninsured for the 1) employed, 2) unemployed spouses of the employed, 3) unemployed children of the employed, 4) self-employed, 5) unemployed spouses of the self-employed, 6) unemployed children of the self-employed, 7) unemployed adults, and 8) unemployed children of the unemployed adults. Predictor variables included union membership, hourly wage, full time employment, full year employment, size of the firm, occupation, industry, demographics, family income, and number of disability bed days among others. PRINCIPAL FINDINGS: Employment-related factors such as union membership, firm size and hourly wage predict coverage for the employed and their dependents. Employment characteristics vary in the size of their effect, however. For example, dependents of employees of larger firms have a higher likelihood of private coverage than the depndents of the employees of small firms. Occupation and industry are important predictors of private coverage for the employed but not for their depndents. The size of the self-employed person's business does not predict probability of coverage for the self-employed, but does predict the likelihood of coverage for dependents. The most consistent positive predictor of private coverage among most subgroups is family income. CONCLUSIONS: The importance of income in predicting private health insurance coverage can not be overemphasized. Income remains a significant predictor of private coverage even when work-related characteristics are held constant. Recent reductions of health benefits to the employed shift more of the burden on providing health insurance coverage to the employees, reducing the probability of privately purchased policies as prices increase. POLICY RELEVANCE: Advocating increases in health insurance coverage throught the work place may no longer be as effective in assuring coverage for the employed and their dependents as employers attempt to defray the costs of health care benefits for their workforce. Policies that can increase the purchasing power of the population can affect the employed, self-employed, and the unemployed alike and can potentially: improve coverage of these populations, reduce the need for public insurance, and alleviate additional inequities in access to health care.
Publication Types:
Keywords:
- Adult
- Child
- Demography
- Employment
- Family Characteristics
- Health Expenditures
- Humans
- Income
- Insurance Coverage
- Insurance, Health
- Medicaid
- Medically Uninsured
- Public Policy
- Unemployment
- economics
- hsrmtgs
Other ID:
UI: 102233480
From Meeting Abstracts