Rand Health Research Highlights. Health Care Coverage for the Nation's Uninsured: Can We Get to Universal Coverage

摘要

The goal of expanding public health insurance programs is to provide coverage to most of the nation's uninsured. But policymakers face a number of challenges in determining whether this goal can be reached. For example, how much will it cost. How should new public programs be financed. How will benefits be distributed. Can expanding insurance be left up to the states. These and related issues are explored in a series of studies by economists Stephen Long and Susan Marquis. Their work draws on data from the Robert Wood Johnson Foundation (RWJF) Family Health Insurance and Employer surveys, conducted in 1993-1994 in Colorado, Florida, Minnesota, New Mexico, New York, North Dakota, Oklahoma, Oregon, Vermont, and Washington. Collectively, these states are similar to all states in their health care systems and population characteristics, and span the variation observed in all 50 states in important population and health policy characteristics. The surveys, which Long and Marquis designed in collaboration with leading survey organizations, compiled extensive insurance, utilization, health status, and demographic information. Among key study findings to date: States vary substantially in the number of uninsured residents and in their population's health and access to care. As a consequence, effects of policies will vary across states. Many states may need federal assistance to expand access.