Medical Care Economic Risk Measuring Financial Vulnerability from Spending on Medical Care (2012) / Chapter Skim
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7 Recap of Issues and Next Steps
7 Recap of Issues and Next Steps
Pages 203-214
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From page 203... ...
OPENING REMARKS Michael O'Grady (NORC at the University of Chicago) observed that a number of methodological data concerns surfaced during the day's discussions.
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From page 204... ...
He observed that once the talk moves away from a survey or an imputation of a survey toward modeling, it is viewed much more as a black box. PANEL REMARKS Pamela Short repeated the question Michael Hurd asked earlier, why a measure of MCER is being developed.
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From page 205... ...
There was some discussion during the workshop about actuarial value, which is one way of comparing policies, as are out-of-pocket limits, deductibles, limits in scope and duration, and covered services. On the issue of assets, Short said she is not sure why the question of counting in assets has been linked to measuring medical care economic risk.
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From page 206... ...
Separate from the affordability of the out-of-pocket costs, exposure is a gray issue as a share of income, on an actuarial value level and translating into what it means for families. The measures do different things, premium as a price of health care, and exposure to out-of-pocket costs, in terms of tracking health reform, not only as an economic burden but also as a way to enable people to get the health care that they need.
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From page 207... ...
Geographic adjustment is also important, as indicated by cross-state variation. Finally, in terms of data, Ziliak said he leans heavily toward moving forward using the CPS ASEC as the data set of choice, in part because of the need to go forward; there is a mandate in the ACA about constructing measures reflecting state differences and medical need.
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From page 208... ...
Of course it is a judgment as to what people think of the different values of the different costs -- the higher out-of-pocket costs on one hand and the greater insurance against risk on the other hand. But it would be really too bad if all there was at the time that the ACA is implemented is a measure comparing the effects of health care reform on just the SPM.
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From page 209... ...
Pamela Short commented that the theory of insurance is that, with something like medical care, only a very small percentage of people will get sick, but it costs a lot of money when that happens. So the idea is to pool that risk, to average it out.
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From page 210... ...
That must be captured, he said, but there are also the benefits to other people of that person's being insured. People who are insured have an opportunity for more efficiently provided health care.
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From page 211... ...
So it is important to think through how narrowly defined those matrixes should be. Many other aspects of medical care, such as oral health, have not traditionally been included in most health care policies.
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From page 212... ...
That was a major motivation for the 1995 NRC panel to say yes, medical care must
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From page 213... ...
Is the appropriate unit of analysis for the ACA the tax unit with dependents? That could be quite different from a broad definition of family in the SPM, which includes all related persons plus cohabiters.
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