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Medical Care for Children: Public Insurance, Private Insurance, and Racial Differences in Utilization

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  • Janet Currie
  • Duncan Thomas

Abstract

Data from two waves of the Child-Mother module of the National Longitudinal Surveys are used to examine the medical care received by children. We compare those covered by Medicaid, by private health insurance and those with no insurance coverage at all. We find there are substantial differences in the impact of public and private health insurance and these effects also differ between blacks and whites. White children on Medicaid tend to have more doctor checkups than any other children and white children on Medicaid or a private insurance plan have a higher number of doctor visits for illness. In contrast, for black children, neither Medicaid nor private insurance coverage is associated with any advantage in terms of the number of doctor visits for illness. Furthermore, black children with private coverage are no more likely than those with no coverage to have doctor checkups; black Medicaid children are more likely than either group to have checkups although the gap is not precisely estimated. We exploit the longitudinal dimension of the data in order to take account of potential selection and thus include child specific fixed effects in the models. The results are robust to the inclusion of these controls for unobserved heterogeneity. They suggest that private and public health insurance mean different things to different children, and that national insurance coverage will not equalize utilization of care.

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Bibliographic Info

Article provided by University of Wisconsin Press in its journal Journal of Human Resources.

Volume (Year): 30 (1995)
Issue (Month): 1 ()
Pages: 135-162

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Handle: RePEc:uwp:jhriss:v:30:y:1995:i:1:p:135-162

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Web page: http://jhr.uwpress.org/

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Cited by:
  1. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
  2. Janet Currie & Patricia Reagan, 1998. "Distance to Hospitals and Children's Access to Care: Is Being Closer Better, and for Whom?," NBER Working Papers 6836, National Bureau of Economic Research, Inc.
  3. Currie, J, 1996. "Do Children of Immigrants Make Differential Use of Public Health Insurance?," Papers 96-13, RAND - Labor and Population Program.
  4. Jonathan Gruber, 2003. "Medicaid," NBER Chapters, in: Means-Tested Transfer Programs in the United States, pages 15-78 National Bureau of Economic Research, Inc.
  5. Janet Currie & John Fahr, 2000. "Medicaid Managed Care: Effects on Children's Medicaid Coverage and Utilization," JCPR Working Papers 156, Northwestern University/University of Chicago Joint Center for Poverty Research.
  6. James Kirby & Toshiko Kaneda, 2010. "Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach," Demography, Springer, vol. 47(4), pages 1035-1051, November.
  7. Carol Rapaport & Christopher A. Trenholm, 2000. "What do we really know about trends in outpatient medical expenditures for children, 1977-1987?," Staff Reports 97, Federal Reserve Bank of New York.
  8. Busch, Susan H. & Duchovny, Noelia, 2005. "Family coverage expansions: Impact on insurance coverage and health care utilization of parents," Journal of Health Economics, Elsevier, vol. 24(5), pages 876-890, September.
  9. Robert Kaestner & Theodore Joyce & Andrew Racine, 1999. "Does Publicly Provided Health Insurance Improve the Health of Low-Income Children in the United States," NBER Working Papers 6887, National Bureau of Economic Research, Inc.
  10. Menno Pradhan & Fadia Saadah & Robert Sparrow, 2003. "Did the Healthcard Program ensure Access to Medical Care for the Poor during Indonesia's Economic Crisis?," Tinbergen Institute Discussion Papers 03-016/2, Tinbergen Institute.
  11. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
  12. Janet Currie & Jeffrey Grogger, 2000. "Medicaid Expansions and Welfare Contractions: Offsetting Effects on Prenatal Care and Infant Health?," NBER Working Papers 7667, National Bureau of Economic Research, Inc.
  13. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
  14. Janet Currie, 1998. "The Effect of Welfare on Child Outcomes: What We Know and What We Need to Know," JCPR Working Papers 26, Northwestern University/University of Chicago Joint Center for Poverty Research.

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