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Insurance and the Utilization of Medical Services Among the Self-Employed

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  • Craig William Perry
  • Harvey Rosen

Abstract

There has been substantial public policy concern over the relatively low rates of health insurance coverage among the self-employed in the United States. We use data from the Medical Expenditure Panel Survey conducted in 1996 to analyze how the self-employed and wage-earners differ both with respect to insurance coverage and utilization of a variety of health care services. Our results suggest that for the self-employed, the link between insurance and utilization of health care services is not as strong as assumed in the policy debate. For a number of medical care services, the self-employed have the same rates of utilization as wage-earners, despite the fact that they are substantially less likely to be insured. And when the self-employed are less likely than wage-earners to utilize a particular medical service, the differences are generally less than one would expect solely on the basis of the difference in insurance coverage rates. The self-employed thus appear to be able to finance access to health care from sources other than insurance. Further, analysis of out-of-pocket expenditures on health care suggests that doing so does not lead to substantial reductions in their ability to consume other goods and services. Finally, there is no evidence that children of the self-employed have less access to health care than the children of wage-earners. Hence, the public policy concern over the relative lack of health insurance among the self-employed may be somewhat misplaced.

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Bibliographic Info

Paper provided by CESifo Group Munich in its series CESifo Working Paper Series with number 580.

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Date of creation: 2001
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Handle: RePEc:ces:ceswps:_580

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  1. Holtz-Eakin, Douglas & Penrod, John R. & Rosen, Harvey S., 1996. "Health insurance and the supply of entrepreneurs," Journal of Public Economics, Elsevier, Elsevier, vol. 62(1-2), pages 209-235, October.
  2. Jonathan Skinner & Elliott Fisher & John E. Wennberg, 2001. "The Efficiency of Medicare," NBER Working Papers 8395, National Bureau of Economic Research, Inc.
  3. Jonathan S. Skinner & John Wennberg, 2000. "How Much Is Enough? Efficiency and Medicare Spending in the Last Six Months of Life," NBER Chapters, National Bureau of Economic Research, Inc, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 169-194 National Bureau of Economic Research, Inc.
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  8. Thomas Philipson & Darius Lakdawalla, 1998. "The Rise in Old Age Longevity and the Market for Long-Term Care," University of Chicago - George G. Stigler Center for Study of Economy and State, Chicago - Center for Study of Economy and State 146, Chicago - Center for Study of Economy and State.
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  15. Campling, R.F., 1987. "Employee Benefits and the Part-Time Worker," Papers, Queen's at Kingston - Sch. of Indus. Relat. Research Essay Series 13, Queen's at Kingston - Sch. of Indus. Relat. Research Essay Series.
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  17. Angus Deaton & Christina Paxson, 1999. "Mortality, Education, Income, and Inequality among American Cohorts," NBER Working Papers 7140, National Bureau of Economic Research, Inc.
  18. Craig William Perry & Harvey S. Rosen, 2001. "The Self-Employed are Less Likely to Have Health Insurance Than Wage Earners. So What?," NBER Working Papers 8316, National Bureau of Economic Research, Inc.
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Cited by:
  1. David Zimmer, 2009. "Insurance Arrangements Among Married Couples: Analysis of Benefit Substitution and Compensating Differentials," Journal of Family and Economic Issues, Springer, Springer, vol. 30(4), pages 428-439, December.
  2. Jonathan Meer & Harvey S. Rosen, 2003. "Insurance and the Utilization of Medical Services," NBER Working Papers 9812, National Bureau of Economic Research, Inc.
  3. Kuo-Liang Chang & George Langelett & Andrew Waugh, 2011. "Health, Health Insurance, and Decision to Exit from Farming," Journal of Family and Economic Issues, Springer, Springer, vol. 32(2), pages 356-372, June.
  4. Jonathan Meer & Harvey S. Rosen, 2002. "Insurance, Health, and the Utilization of Medical Services," Working Papers, Princeton University, Department of Economics, Center for Economic Policy Studies. 117, Princeton University, Department of Economics, Center for Economic Policy Studies..
  5. Ahearn, Mary Clare & El-Osta, Hisham & Mishra, Ashok K., 2013. "Considerations in Work Choices of U.S. Farm Households: The Role of Health Insurance," Journal of Agricultural and Resource Economics, Western Agricultural Economics Association, Western Agricultural Economics Association, vol. 38(1), April.
  6. David Zimmer, 2010. "Health Insurance and Health Care Demand Among the Self-employed," Journal of Labor Research, Springer, Springer, vol. 31(1), pages 1-19, March.
  7. Craig William Perry & Harvey S. Rosen, 2001. "The Self-Employed are Less Likely to Have Health Insurance Than Wage Earners. So What?," NBER Working Papers 8316, National Bureau of Economic Research, Inc.
  8. Kelly Edmiston, 2004. "The role of small business in economic development," Community Affairs Research Working Paper, Federal Reserve Bank of Kansas City 2005-01, Federal Reserve Bank of Kansas City.

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