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

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  • Craig William Perry
  • Harvey S. 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 generally do not seem very large. 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 concerns that the relative lack of health insurance among the self-employed substantially reduces utilization of health care services or creates economic hardship appear to be misplaced.

Suggested Citation

  • Craig William Perry & Harvey S. Rosen, 2001. "Insurance and the Utilization of Medical Services Among the Self-Employed," NBER Working Papers 8490, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:8490
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    1. repec:pri:cepsud:85rosen is not listed on IDEAS
    2. Meer, Jonathan & Rosen, Harvey S., 2004. "Insurance and the utilization of medical services," Social Science & Medicine, Elsevier, vol. 58(9), pages 1623-1632, May.
    3. 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.
    4. Kuo-Liang Chang & George Langelett & Andrew Waugh, 2011. "Health, Health Insurance, and Decision to Exit from Farming," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 356-372, June.
    5. 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.
    6. Kelly Edmiston, 2004. "The role of small business in economic development," Community Affairs Research Working Paper 2005-01, Federal Reserve Bank of Kansas City.
    7. 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.
    8. 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, vol. 38(1), April.

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    JEL classification:

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

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