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    Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care

    ISBN-10: 0309266041
    ISBN-13: 9780309266048
    Author(s): Michael J. O'Grady, Gooloo S. Wunderlich
    Description: The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless  More...
    List price: $57.00
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    List Price: $57.00
    Publisher: Natl Academy Pr
    Binding: Paperback
    Pages: 300
    Size: 6.00" wide x 8.75" long x 1.00" tall
    Weight: 1.100
    Language: English

    The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families' economic security or their income available for other basic needs. In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families' disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel's recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM. The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies - whether part of the ACA or other policies - are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report.

    Summary
    Review and Recommendations
    Introduction
    Concepts of Medical Care Economic Burden and Risk
    Concepts of Resources
    Measures of Medical Care Economic Risk and Recommended Approach
    Data Sources
    Implementing Measures of Medical Care Economic Burden and Risk
    References
    Acronyms and Abbreviations
    Appendix: Biographical Sketches of Panel Members and Staff
    Resources for the Study: Developing a Measure of Medical Care Economic Risk-Workshop Summary
    Introduction
    Context for the Workshop
    Measuring Medical Care Economic Risk
    Issues in the Development of Thresholds
    Issues in Denning Resources
    Implementation Issues
    Recap of Issues and Next Steps
    References
    Appendix: Workshop Agenda and Presenters
    Resources for the Study: Background Papers
    Conceptual Framework for Measuring Medical Care Economic Risk
    Incorporating Data on Assets into Measures of Financial Burdens of Health
    An Assessment of Data Sources for Measuring Medical Care Economic Risk

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