• Kaiser’s Women’s Health Care Survey

    I’ve been poring over the chartbook from Kaiser’s Women’s Health Care Survey:

    The Women’s Health Care Chartbook presents findings from a national survey of women ages 18 to 64 and provides a look at the experience of women in the health care system. The chartbook includes data on insurance coverage, affordability of and access to care, use of health care services, prevention, and family health. The survey was conducted in 2008 and builds on data collected during previous women’s health surveys conducted by the Kaiser Family Foundation in 2001 and 2004.

    Two things that have jumped out at me so far, as I perused Chapter 2, Health Coverage. Here’s a chart I made from data in a table on page 11:

    This is the percent of women who report their health status as “fair” or “poor”. What I want you to see is how much adverse selection is already affecting the health insurance market. Most of the people who get insurance in the individual market are not in fair or poor health. Much of that is because if you’re sick, you can’t get a policy. That’s what guaranteed issue is supposed to fix. I also want you to note how relatively healthy the employer-sponsored insurance market is.

    In general, private insurance is covering relatively healthy people. More unhealthy people are uninsured. The most unhealthy population is the Medicaid population. Yet many complain how much Medicaid costs, even though it’s spending relatively little on its population. Many want to cut Medicaid spending, even though it’s the population that likely needs care the most.

    Here’s another chart I got right from the report, on page 13:

    There’s a meme out there that the poor are well covered by Medicaid. I want you to notice, though, the percent of women who are uninsured. Almost 30% of women who are near poor and 35% of women making less than the poverty line are uninsured. Also note that only 38% of women who make less than the poverty line are on Medicaid. Only 16% of women who are near-poor are on Medicaid.

    And, once again, many want to cut that.

    UPDATE: Fixed a typo!

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    • Well not to disagree with you but some part of this, how big a part of it is important, is due to conscientious people are more likely to not be poor, more likely to have insurance and more likely to be healthy. I have a friend, lets call him John, who spent years doing all kinds of drugs and drinking heavily. John I think is on medicare due to being disabled (it maybe medicaid) and he is in and out of the hospital with symptoms related to neuropathy and a compromised immune system. I have a another friend in the health insurance business and he estimates that the bill for all John’s health care runs more than $1,000,000/year. Anyway if John was somehow was making $80,000/ year when he still had no health problem he would not have bought health insurance, he would have bought more and better drugs.

      So it is not necessarily all adverse selection.

    • In regards to the percentage of women who are poor or near-poor but remain uninsured, one must take care to remember that this population may also contain women who are currently eligible for Medicaid but do not enroll for a variety of reasons (stigma, time constraints, working 2+ jobs, etc.). In 2014, with the Medicaid expansion under ACA, many of the previously eligible will take up insurance to avoid the individual mandate penalties so hopefully that percentage of poor and near-poor without coverage will fall.

      Of course, all of this relies on the status quo (ACA) continuing through 2014.

      And I’m confused about Floccina’s comment…

    • Honest question: is self-reporting actually a good judge of a respondent’s health status?