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How Much Uncompensated Care do Doctors Provide?

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  • Jonathan Gruber
  • David Rodriguez

Abstract

The magnitude of provider uncompensated care has become an important public policy issue. Yet existing measures of uncompensated care are flawed because they compare uninsured payments to list prices, not to the prices actually paid by the insured. We address this issue using a novel source of data from a vendor that processes financial data for almost 4000 physicians. We measure uncompensated care as the net amount that physicians lose by lower payments from the uninsured than from the insured. Our best estimate is that physicians provide negative uncompensated care to the uninsured, earning more on uninsured patients than on insured patients with comparable treatments. Even our most conservative estimates suggest that uncompensated care amounts to only 0.8% of revenues, or at most $3.2 billion nationally. These results highlight the important distinction between charges and payments, and point to the need for a re-definition of uncompensated care in the health sector going forward.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13585.

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Date of creation: Nov 2007
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Publication status: published as Gruber, Jonathan & Rodriguez, David, 2007. "How much uncompensated care do doctors provide?," Journal of Health Economics, Elsevier, vol. 26(6), pages 1151-1169, December.
Handle: RePEc:nbr:nberwo:13585

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Cited by:
  1. David Ong & Chun-Lei Yang, 2014. "Pro Bono Work and Trust in Expert Fields," CESifo Working Paper Series 4897, CESifo Group Munich.
  2. Xuezheng Qin & Gordon Liu, 2013. "Does the US health care safety net discourage private insurance coverage?," The European Journal of Health Economics, Springer, Springer, vol. 14(3), pages 457-469, June.
  3. Juergen Jung & Chung Tran, 2014. "Market Inefficiency, Insurance Mandate and Welfare: U.S. Health Care Reform 2010," Working Papers, Towson University, Department of Economics 2014-01, Towson University, Department of Economics, revised Feb 2014.
  4. Jonathan Gruber & Helen Levy, 2009. "The Evolution of Medical Spending Risk," Journal of Economic Perspectives, American Economic Association, American Economic Association, vol. 23(4), pages 25-48, Fall.
  5. Neale Mahoney, 2012. "Bankruptcy as Implicit Health Insurance," NBER Working Papers 18105, National Bureau of Economic Research, Inc.
  6. Jonathan Gruber, 2008. "Covering the Uninsured in the United States," Journal of Economic Literature, American Economic Association, vol. 46(3), pages 571-606, September.

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