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August 1995, Vol. 118, No. 8
Geoffrey D. Paulin and Elizabeth M. Dietz
H ealth insurance coverage is an important ingredient in the maintenance of good health. This is particularly true for families with children. According to Peter J. Cunningham and Alan C. Monheit, children in families without health insurance coverage are "at a disadvantage regarding access to, quality of, and continuity of health care."1 Judith D. Kasper finds that uninsured children under 18 are less likely to see a physician at least once during the past year, and are less likely to visit a physician for an immunization or general check-up.2 Such regular, preventive medical care is especially important for the children who, in general, are more prone to illness than adults. Without preventive care, families may face large medical expenses as their children grow up.
Additionally, health care costs have risen substantially in recent years. Data from the Consumer Price Index show that the price of medical care has risen at a much higher rate than for all other goods and services. From 1989-94, the medical care index increased 41.3 percent, compared with the 18.2 percent for all items less medical care. In 1993, the Nation's health care costs rose to $884.2 billion, up 7.8 percent from 1992.3 A recent article by Geoffrey D. Paulin and Wolf D. Weber suggests that as a result of these large increases, the direct costs of funding health care have been shifting from business and government to families, thus affecting their expenditures for nonhealth items.4
Meanwhile , in 1992, more than 8 million American children under age 18 had no health insurance coverage of any kind.5 While many of the poorest families receive health insurance in form of government-provided Medicaid benefits6 the percentage of children without public or private health insurance coverage grew by more than 40 percent between 1977 and 1987.7
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1 Peter J. Cunningham and Alan C. Monheit, "insuring the Children: A Decade of Change."Health Affairs, Winter 1990, p.78.
2 Judith D. Kasper, "The Importance of Type of Usual Source of Care for Children's Physician Access and Expenditures," Medical Care, May 1987, 25(5), pp.386-98, especially tables 4 and 7.
3 HHS News, U.S.Department of health and Human Services, November 1994, p.1
4 Geoffrey D. Paulin, and Wolf D. Weber, "The effects of health insurance on consumer spending." Monthly Labor Review, March 1995, pp.34-54.
5 Statistical Abstract of the United States: 1994 ( U.S. Bureau of the Census, 1994), table no. 165. "Health Insurance Coverage status, by Selected Characteristics: 1987-92," p. 118.
6 Cunningham and Monheit, pp.77-78.
7 Cunningham and Monheit, p. 80. Based on data from the 1977 National Medical Care Expenditure Survey, 1997 and the national medical Expenditure Survey, 1987.
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