Medical Care Economic Risk Measuring Financial Vulnerability from Spending on Medical Care (2012) / Chapter Skim
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An Assessment of Data Sources for Measuring Medical Care Economic Risk--John L. Czajka
An Assessment of Data Sources for Measuring Medical Care Economic Risk--John L. Czajka
Pages 281-292
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From page 281... ...
Panel on Poverty and Family Assistance recommended that the federal government revise its decades-old methodology for measuring poverty by updating the thresholds used to define basic needs; replacing money income with disposable income (which subtracts taxes and the costs incurred in going to work) as a measure of the resources available to meet these needs; recognizing the role of federal and state assistance programs in helping low-income families address basic needs by including the cash value of noncash benefits in these resources; and expanding the family unit over which these thresholds and income are calculated (National Research Council, 1995)
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From page 282... ...
With the SPM about to become reality, attention has refocused on the MCRI, and the charge to the Panel on Measuring Medical Care Risk in Conjunction with the New Supplemental Income Poverty Measure is to examine the state of the science in developing a measure of medical care risk that is feasible to produce and can be used to track changes in medical care economic risk as the implementation of health care reform progresses. Data issues loom large, compounded by complex conceptual issues.
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From page 283... ...
With a prospective measure, which the 1995 NRC panel recommended, actual expenditures in the recent past, though not unimportant, become less important than measures of current health status on the one hand and the limits of insurance coverage on the other -- both of which relate to the likelihood of incurring medical expenditures in excess of what an individual or family can afford to pay. In assessing data availability, I consider all of these characteristics.
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From page 284... ...
The available data on income, then, include the official measure of money income -- which is also used to estimate poverty -- and the measure of disposable income that will be used for the SPM. This latter measure of income includes the cash value of noncash benefits (such as the Supplemental Nutrition Assistance Program, formerly the Food Stamp Program)
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From page 285... ...
Excluding the wealthiest families increased this fraction to 74 percent, but it is clear from this that adding measures of assets without field-testing, which the Census Bureau currently lacks the resources to support, is risky. MEPS collects data on multiple sources of income that, in the aggregate, correspond closely to the CPS concept of money income.
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From page 286... ...
In its initial year, 1996, MEPS also collected and abstracted detailed information from the health insurance plan booklets for sample members covered by private insurance. Similar data collected as a supplement to the 1987 National Medical Expenditure Survey provided a critical input to Short and Banthin's (1995)
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From page 287... ...
The limitations of the CPS ASEC measure of health insurance coverage are well known and thoroughly documented. Briefly, the CPS ASEC asks respondents about their health insurance coverage in the past year, but the survey's estimates of the uninsured compare more closely to other surveys' estimates of people uninsured at a point in time (that is, at the time of the survey or in a particular month)
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From page 288... ...
Compounding this problem, evidence began to emerge that the quality of SIPP's income and asset data had deteriorated. In addition, SIPP continued to use an antiquated processing system that contributed to a decline in timeliness, and an established pattern of budget cutbacks and unpredictable sample reductions had made it clear that SIPP lacked the stability desired to support a key national indicator.
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From page 289... ...
MEPS collects essentially all of the data elements that would be needed to construct alternative versions of an MCRI whereas the CPS ASEC is missing critical variables for certain variants on an MCRI. However, the
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From page 290... ...
The other significant advantage of the CPS ASEC is its sample size, which is five times that of the largest recent MEPS samples. The greater CPS ASEC sample size would support more precise estimates generally while allowing more extensive subgroup analysis.
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From page 291... ...
Paper presented at the Household Survey Producers Workshop, June, National Research Council, Wash ington, DC. Interagency Technical Working Group on Developing a Supplemental Poverty Measure.
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