The effects of community uninsurance on health care quality for the insured population.

摘要

An important aspect of the ongoing health care reform of 2010 is to provide health coverage to the uninsured, the rising population of which has remained a significant challenge to overcome. Previously, efforts to reduce the number of people without health insurance have been centered on a moral rationale that providing care for the medically indigent was "the right thing" to do. However, recent evidence suggests that it might be in the best interest of people who are already insured to be concerned about the rate of uninsurance in their communities because of a potential negative spillover effect. Using four waves of the Community Tracking Study (CTS) Household Survey, from 1996-1997, 1998-1999, 2000-2001, and 2003, this paper attempts to investigate whether or not this type of spillover exists and to what extent it affects the insured population. The results show strong evidence linking the community uninsurance rate negatively to the quality of care available to the insured, specifically in terms of access to care and service utilization. Therefore, the issue of high uninsurance rates should not be overlooked by the insured population since they appear to bear some consequences of this issue themselves.