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The Self-Employed are Less Likely to Have Health Insurance Than Wage Earners. So What?

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  • Craig William Perry
  • Harvey S. Rosen

Abstract

There is considerable public policy concern over the relatively low rates of health insurance coverage among the self-employed in the United States. Presumably, the reason for the concern is that their low rates of insurance lead to worse health outcomes. We use data from the Medical Expenditure Panel Survey conducted in 1996 to analyze how the self-employed and wage-earners differ with respect to insurance coverage and health status. Using a variety of ways to measure health status, we find that the relative lack of health insurance among the self-employed does not affect their health. For virtually every subjective and objective measure of health status, the self-employed and wage earners are statistically indistinguishable from each other. Further, we present some evidence that this phenomenon is not due to the fact that individuals who select into self-employment are healthier than wage-earners, ceteris paribus. Thus, the public policy concern with the relative lack of health insurance among the self-employed may be somewhat misplaced.

Suggested Citation

  • 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.
  • Handle: RePEc:nbr:nberwo:8316
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    Cited by:

    1. James Bailey, 2017. "Health insurance and the supply of entrepreneurs: new evidence from the affordable care act," Small Business Economics, Springer, vol. 49(3), pages 627-646, October.
    2. Jonathan Meer & Harvey S. Rosen, 2002. "Insurance, Health, and the Utilization of Medical Services," Working Papers 117, Princeton University, Department of Economics, Center for Economic Policy Studies..
    3. Meer, Jonathan & Rosen, Harvey S., 2004. "Insurance and the utilization of medical services," Social Science & Medicine, Elsevier, vol. 58(9), pages 1623-1632, May.
    4. Avi Dor & Joseph Sudano & David W. Baker, 2003. "The Effects of Private Insurance on Measures of Health: Evidence from the Health and Retirement Study," NBER Working Papers 9774, National Bureau of Economic Research, Inc.
    5. Joni Hersch, 2004. "A Workers' Lobby to Provide Portable Benefits," NBER Chapters, in: Emerging Labor Market Institutions for the Twenty-First Century, pages 207-228, National Bureau of Economic Research, Inc.
    6. Craig William Perry & Harvey Rosen, 2001. "Insurance and the Utilization of Medical Services Among the Self-Employed," CESifo Working Paper Series 580, CESifo.
    7. James Thornton & Jennifer Rice, 2008. "Does extending health insurance coverage to the uninsured improve population health outcomes?," Applied Health Economics and Health Policy, Springer, vol. 6(4), pages 217-230, October.
    8. José A. Pagán & Andrea Puig & Beth J. Soldo, 2007. "Health insurance coverage and the use of preventive services by Mexican adults," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1359-1369.
    9. Raquel Fonseca & Simon Lord, 2015. "Les déterminants du travail autonome au Québec et au Canada (1993-201," Cahiers de recherche 1517, Chaire de recherche Industrielle Alliance sur les enjeux économiques des changements démographiques.
    10. José A. Pagán & Andrea Puig & Beth J. Soldo, 2007. "Health insurance coverage and the use of preventive services by Mexican adults," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1359-1369, December.
    11. David Zimmer, 2009. "Insurance Arrangements Among Married Couples: Analysis of Benefit Substitution and Compensating Differentials," Journal of Family and Economic Issues, Springer, vol. 30(4), pages 428-439, December.
    12. Aparna Mathur, 2010. "Health insurance and job creation by the self-employed," Small Business Economics, Springer, vol. 35(3), pages 299-317, October.
    13. Jonathan Klick & Sara Markowitz, 2006. "Are mental health insurance mandates effective? Evidence from suicides," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 83-97, January.
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    15. Jonathan Meer & Harvey S. Rosen, 2002. "Insurance, Health, and the Utilization of Medical Services," Working Papers 117, Princeton University, Department of Economics, Center for Economic Policy Studies..
    16. Y. Machnes, 2006. "The demand for private health care under national health insurance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(4), pages 265-269, December.
    17. Alejandro Gaviria & Carlos Medina & Carolina Mejía, 2006. "Evaluating The Impact Of Health Care Reform In Colombia: From Theory To Practice," Documentos CEDE 2647, Universidad de los Andes, Facultad de Economía, CEDE.
    18. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334, March.
    19. David Zimmer, 2010. "Health Insurance and Health Care Demand Among the Self-employed," Journal of Labor Research, Springer, vol. 31(1), pages 1-19, March.
    20. Betregiorgis Zegeye & Ziad El-Khatib & Edward Kwabena Ameyaw & Abdul-Aziz Seidu & Bright Opoku Ahinkorah & Mpho Keetile & Sanni Yaya, 2021. "Breaking Barriers to Healthcare Access: A Multilevel Analysis of Individual- and Community-Level Factors Affecting Women’s Access to Healthcare Services in Benin," IJERPH, MDPI, vol. 18(2), pages 1-15, January.
    21. Denise Doiron & Glenn Jones & Elizabeth Savage, 2006. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance, CHERE Working Paper 2006/2," Working Papers 2006/2, CHERE, University of Technology, Sydney.
    22. Raquel Fonseca & Simon Lord, 2015. "Les déterminants du travail autonome au Québec et au Canada (1993-2010)," CIRANO Papers 2015n-12f, CIRANO.
    23. Yingying Dong, 2013. "How Health Insurance Affects Health Care Demand—A Structural Analysis Of Behavioral Moral Hazard And Adverse Selection," Economic Inquiry, Western Economic Association International, vol. 51(2), pages 1324-1344, April.
    24. Alejandro Arrieta & Ariadna García Prado & Giota Panopoulou, 2012. "Enrolling the Self-Employed in Mandatory Health Insurance in Colombia: are we missing other factors?," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 1213, Departamento de Economía - Universidad Pública de Navarra.

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    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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