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Do the uninsured demand less care? Evidence from Maryland’s hospitals

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  • Amanda Cook

    (Bowling Green State University)

Abstract

Uninsured individuals receive fewer healthcare services for at least three reasons: responsibility for the entire bill, higher prices, and potential provider reductions for concern of nonpayment. I isolate reductions when uninsured patients are solely financially responsible by capitalizing on Maryland’s highly regulated health care system. Prices are set by the state, are uniform across all patients, and hospitals are compensated for free care and bad debt. I use a unique feature of the data, multiple readmissions for patients who gain or lose insurance between visits, to isolate the reductions in quantity demanded when individuals are faced with paying the full price without an insurance contribution. A Blinder–Oaxaca decomposition estimates uninsured individuals receive 6% fewer services after accounting for differences in patient, illness, and hospital characteristics than when these same individuals are insured.

Suggested Citation

  • Amanda Cook, 2020. "Do the uninsured demand less care? Evidence from Maryland’s hospitals," International Journal of Health Economics and Management, Springer, vol. 20(3), pages 251-276, September.
    • Handle: RePEc:kap:ijhcfe:v:20:y:2020:i:3:d:10.1007_s10754-020-09280-4
    DOI: 10.1007/s10754-020-09280-4
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    References listed on IDEAS

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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 7th September 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-09-07 11:00:07

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    More about this item

    Keywords

    Health insurance; Uninsured; Demand for health care; Health and inequality; Regulation;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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