The effect of the availability of charity care to the uninsured on the demand for private health insurance

Bradley Herring

doi:10.1016/j.jhealeco.2004.08.003

The effect of the availability of charity care to the uninsured on the demand for private health insurance

Bradley Herring

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

The economic reasons why some people do not obtain health insurance are unclear. In this paper, I test the hypothesis that the availability of charity care to the uninsured reduces the likelihood of obtaining private coverage. I utilize variation in the availability of charity care across the different markets in the Community Tracking Study's Household Survey (CTS-HS) using an "access to care" measure of the uninsured's cost-related difficulties in obtaining medical care, to both aggregate across the various "safety net" providers and control for its potentially endogenous supply. I find evidence supporting this hypothesis for low-income people, in both the individual market and the employment-based group market. I also estimate a joint model of offer and take-up decisions for the group market sample and find that the availability of charity care reduces low-income workers' offer rates but not their take-up rates.

Original language	English (US)
Pages (from-to)	225-252
Number of pages	28
Journal	Journal of health economics
Volume	24
Issue number	2
DOIs	https://doi.org/10.1016/j.jhealeco.2004.08.003
State	Published - Mar 2005
Externally published	Yes

Keywords

Charity care
Private health insurance
Uninsured

ASJC Scopus subject areas

Health Policy
Public Health, Environmental and Occupational Health

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10.1016/j.jhealeco.2004.08.003

Cite this

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title = "The effect of the availability of charity care to the uninsured on the demand for private health insurance",

abstract = "The economic reasons why some people do not obtain health insurance are unclear. In this paper, I test the hypothesis that the availability of charity care to the uninsured reduces the likelihood of obtaining private coverage. I utilize variation in the availability of charity care across the different markets in the Community Tracking Study's Household Survey (CTS-HS) using an {"}access to care{"} measure of the uninsured's cost-related difficulties in obtaining medical care, to both aggregate across the various {"}safety net{"} providers and control for its potentially endogenous supply. I find evidence supporting this hypothesis for low-income people, in both the individual market and the employment-based group market. I also estimate a joint model of offer and take-up decisions for the group market sample and find that the availability of charity care reduces low-income workers' offer rates but not their take-up rates.",

keywords = "Charity care, Private health insurance, Uninsured",

author = "Bradley Herring",

note = "Funding Information: This paper is drawn from my dissertation at the University of Pennsylvania, and I am very grateful for assistance from Mark Pauly, Patricia Danzon, Howard Kunreuther, Sean Nicholson, and Jerry Rosenbloom. I also wish to acknowledge very helpful comments from Li-Wei Chao, two anonymous reviewers and editor Joe Newhouse at the Journal, and various seminar participants at Yale, Minnesota, UAB, Harvard, and the 2003 iHEA. Finally, I am grateful for funding from NIH's NRSA award 2-T32-HS-00009 and from the Robert Wood Johnson Foundation.",

year = "2005",

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doi = "10.1016/j.jhealeco.2004.08.003",

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N1 - Funding Information: This paper is drawn from my dissertation at the University of Pennsylvania, and I am very grateful for assistance from Mark Pauly, Patricia Danzon, Howard Kunreuther, Sean Nicholson, and Jerry Rosenbloom. I also wish to acknowledge very helpful comments from Li-Wei Chao, two anonymous reviewers and editor Joe Newhouse at the Journal, and various seminar participants at Yale, Minnesota, UAB, Harvard, and the 2003 iHEA. Finally, I am grateful for funding from NIH's NRSA award 2-T32-HS-00009 and from the Robert Wood Johnson Foundation.

PY - 2005/3

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N2 - The economic reasons why some people do not obtain health insurance are unclear. In this paper, I test the hypothesis that the availability of charity care to the uninsured reduces the likelihood of obtaining private coverage. I utilize variation in the availability of charity care across the different markets in the Community Tracking Study's Household Survey (CTS-HS) using an "access to care" measure of the uninsured's cost-related difficulties in obtaining medical care, to both aggregate across the various "safety net" providers and control for its potentially endogenous supply. I find evidence supporting this hypothesis for low-income people, in both the individual market and the employment-based group market. I also estimate a joint model of offer and take-up decisions for the group market sample and find that the availability of charity care reduces low-income workers' offer rates but not their take-up rates.

AB - The economic reasons why some people do not obtain health insurance are unclear. In this paper, I test the hypothesis that the availability of charity care to the uninsured reduces the likelihood of obtaining private coverage. I utilize variation in the availability of charity care across the different markets in the Community Tracking Study's Household Survey (CTS-HS) using an "access to care" measure of the uninsured's cost-related difficulties in obtaining medical care, to both aggregate across the various "safety net" providers and control for its potentially endogenous supply. I find evidence supporting this hypothesis for low-income people, in both the individual market and the employment-based group market. I also estimate a joint model of offer and take-up decisions for the group market sample and find that the availability of charity care reduces low-income workers' offer rates but not their take-up rates.

KW - Charity care

KW - Private health insurance

KW - Uninsured

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The effect of the availability of charity care to the uninsured on the demand for private health insurance

Abstract

Keywords

ASJC Scopus subject areas

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