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The Economic Case or Health Equity

Paper Session

Friday, Jan. 5, 2018 10:15 AM - 12:15 PM

Marriott Philadelphia Downtown, Meeting Room 309
Hosted By: National Economic Association
  • Chair: Samuel L. Myers Jr., University of Minnesota

Medicaid, Access to Care and Times of Economic Downturn

Joseph Benitez
,
University of Louisville
Victoria Perez
,
Indiana University
Eric Seiber
,
Ohio State University

Abstract

During the Great Recession of 2007 to 2009, U.S. households experienced elevated joblessness, housing insecurity, and financial bankruptcy. Consequently, regular access to medical care largely diminished as a substantial number of households lost access to employer sponsored health insurance coverage. Losing access to health coverage may have a devastating blow on households’ ability to pay for needed medical care; however, Medicaid—the public health insurance program for low-income income adults—saw accelerated uptake in this period. The upper income limits for Medicaid eligibility vary across states, thus access to a “safety net” resource to pay for health care needs also varies across states. With this source of state-level variation, we intend to determine if some of the adverse health effects (e.g. uninsurance, cost-related barriers to care, doctor visitation) of the recession were potentially slowed in states with higher-than-average Medicaid eligibility limits, by testing the interaction of state Medicaid eligibility limits with rises in unemployment during the recession. As a major component to the U.S. health care financing, Medicaid is credited with extending access to care among some of the country’s vulnerable populations—though the extent that extended eligibility to adults whom, at any time, would be “at risk” for Medicaid eligibility helps shield households from the more negative effects of recessions is not well understood. If variation in Medicaid eligibility allows states to absorb potentially disastrous effects to households during times of economic uncertainty, then it may be an additional indicator Medicaid generosity has value to households beyond simply health care access.

The Economic Case for Health Equity in Minnesota

Huda Ahmed
,
University of Minnesota
Michelle Allen
,
University of Minnesota
Thomas Durfee
,
University of Minnesota
Darrick Hamilton
,
New School
Katerina Kent
,
University of Minnesota

Abstract

In 2014, the Minnesota Center or Health Statistics reported that Minnesota has among the best average health outcomes in the nation. However, these health outcomes are not evenly distributed. Many racial and ethnic populations and recent immigrant communities report persistent poor health which is not explainable with personal health behaviors alone. In order to advocate for targeted strategies to improve health, communities are supporting the social equity argument for health by making the economic case for addressing health inequity. This paper identifies health disparities in Minnesota according to race, ethnicity, and national origin, identifies the economic cost of these disparities, and provides a framework or identifying the degree to which social determinants of health contribute to the disparity.

Estimating the Economic Burden of Racial Health Inequalities in the United States

Darrell Gaskin
,
Johns Hopkins University
Thomas LaVeist
,
Johns Hopkins University
Patrick Richard
,
Uniformed Services University of the Health Sciences

Abstract

The primary hypothesis of this study is that racial/ethnic disparities in health and health care impose costs on numerous aspects of society, both direct health care costs and indirect costs such as loss of productivity. The authors conducted three sets of analysis, assessing: (1) direct medical costs and (2) indirect costs, using data from the Medical Expenditure Panel Survey (2002-2006) to estimate the potential cost savings of eliminating health disparities for racial/ethnic minorities and the productivity loss associated with health inequalities for racial/ethnic minorities, respectively; and (3) costs of premature death, using data from the National Vital Statistics Reports (2003-2006). They estimate that eliminating health disparities for minorities would have reduced direct medical care expenditures by about $230 billion and indirect costs associated with illness and premature death by more than $1 trillion for the years 2003-2006 (in 2008 inflation-adjusted dollars). We should address health disparities because such inequities are inconsistent with the values of our society and addressing them is the right thing to do, but this analysis shows that social justice can also be cost effective.
Discussant(s)
Joseph Benitez
,
University of Louisville
Thomas Durfee
,
University of Minnesota
Darrell Gaskin
,
Johns Hopkins University
JEL Classifications
  • I1 - Health