The cost of insuring the uninsured in the U.S.

Objectives: This study included two overarching objectives. Through a systematic review of the literature published between 1990 and 2012, the first objective aimed to assess whether insuring the uninsured would result in higher costs compared to insuring the currently insured. Studies that quantified the actual costs associated with insuring the uninsured in the U.S. were included. Based upon 2009 data from the Medical Expenditure Panel Survey (MEPS), the second objective aimed to assess and compare the self-reported health of populations with four different insurance statuses. The second part of this study involved a secondary data analysis of both currently insured and currently uninsured individuals who participated in the MEPS in 2009. The null hypothesis was that there were no differences across the four categories of health insurance status for self-reported health status and healthcare service use. The alternative hypothesis was that were differences across the four categories of health insurance status for self-reported health status and healthcare service use. Methods: For the systematic review, three databases were searched using search terms to identify studies that actually quantified the cost of insuring the uninsured. Thirteen studies were selected, discussed, and summarized in tables. For the secondary data analysis of MEPS data, this study compared four categories of health insurance status: (1) currently uninsured persons who will become eligible for Medicaid under the Patient Protection and Affordable Care Act (PPACA) healthcare reforms in 2014; (2) currently uninsured persons who will be required to buy private insurance through the PPACA health insurance exchanges in 2014; (3) persons currently insured under Medicaid or SCHIP; and (4) persons currently insured with private insurance. The four categories were compared on the basis of demographic information, health status information, and health conditions with relatively high prevalence. Chi-square tests were run to determine if there were differences between the four groups in regard to health insurance status and health status. With some exceptions, the two currently insured groups had worse self-reported health status compared to the two currently uninsured groups. Results: The thirteen studies that met the inclusion criteria for the systematic review included: (1) three cost studies from 1993, 1995, and 1997; (2) four cost studies from 2001, 2003, and 2004; (3) one study of disabilities and one study of immigrants; (4) two state specific studies of uninsured status; and (5) two current studies of healthcare reform. Of the thirteen studies reviewed, four directly addressed the study question about whether insuring the uninsured was more or less expensive than insuring the currently insured. All four of the studies provided support for the study finding that the cost of insuring the uninsured would generally not be higher than insuring those already insured. One study indicated that the cost of insuring the uninsured would be less expensive than insuring the population currently covered by Medicaid, but more expensive to insure than the populations of those covered by employer-sponsored insurance and non-group private insurance. While the nine other studies included in the systematic review discussed the costs associated with insuring the uninsured population, they did not directly compare the costs of insuring the uninsured population with the costs associated with insuring the currently insured population. For the MEPS secondary data analysis, the results of the chi-square tests indicated that there were differences in the distribution of disease status by health insurance status. As anticipated, with some exceptions, the uninsured reported lower rates of disease and healthcare service use. However, for the variable attention deficit disorder, the uninsured reported higher disease rates than the two insured groups. Additionally, for the variables high blood pressure, high cholesterol, and joint pain, the currently insured under Medicaid or SCHIP group reported a lower rate of disease than the two currently insured groups. This result may be due to the lower mean age of the currently insured under Medicaid or SCHIP group. Conclusion: Based on this study, with some exceptions, the costs for insuring the uninsured should not exceed healthcare-related costs for insuring the currently uninsured. The results of the systematic review indicated that the U.S. is already paying some of the costs associated with insuring the uninsured. PPACA will expand health insurance coverage to millions of Americans who are currently uninsured, as the individual mandate and insurance market reforms will require. Because many of the currently uninsured are relatively healthy young persons, the costs associated with expanding insurance coverage to the uninsured are anticipated to be relatively modest. However, for the purposes of construing these results, it is important to note that once individuals obtain insurance, it is anticipated that they will use more healthcare services, which will increase costs. (Abstract shortened by UMI.)^

The development of the psychologist's professional knowledge : A study of graduated in the U.N.L.P., their insert in the educational field

Los estudios sobre la formación de profesores en psicología nos fueron situando en el proceso de construcción del conocimiento profesional tanto en profesores como en psicólogos que ejercen la docencia, visualizando el papel que en él asumen los conocimientos construidos en los ámbitos académico y profesional y la relación entre ambos.

The development of the psychologist's professional knowledge : A study of graduated in the U.N.L.P., their insert in the educational field

Los estudios sobre la formación de profesores en psicología nos fueron situando en el proceso de construcción del conocimiento profesional tanto en profesores como en psicólogos que ejercen la docencia, visualizando el papel que en él asumen los conocimientos construidos en los ámbitos académico y profesional y la relación entre ambos.

The development of the psychologist's professional knowledge : A study of graduated in the U.N.L.P., their insert in the educational field

Los estudios sobre la formación de profesores en psicología nos fueron situando en el proceso de construcción del conocimiento profesional tanto en profesores como en psicólogos que ejercen la docencia, visualizando el papel que en él asumen los conocimientos construidos en los ámbitos académico y profesional y la relación entre ambos.

Internet Civil Liberties in the U.S. and the Protection of the Modern Terrorist

This capstone examines the civil liberties of the modern terrorist and explicates the right to freedom of speech for terrorist organizations and their use of the internet. Terrorist organizations use the internet to promote ideas, recruit members, organize the flow of information, and coordinate actions. During the war on terror the US Patriot Act became law allowing for U.S. government censorship and surveillance of internet traffic and many believe these acts are a threat to civil liberties. Terrorist organizations have the right to express their views, however unpopular, and censoring or restricting web sites diminishes civil liberties for all, which democracies and liberal societies are founded upon.

1 + 1 = 3? EU-US voting cohesion in the United Nations General Assembly. EU Diplomacy Paper 07/2012, September 2012

This paper investigates the factors that explain the voting cohesion of the United States (US) and the European Union (EU) on foreign policy issues in the United Nations General Assembly (UNGA). It is often argued that the EU and the US are simply too different to cooperate within international organizations and thus to vote the same way, for example, in the UNGA. However, there is still a lack of research on this point and, more importantly, previous studies have not analyzed which factors explain EU-US voting cohesion. In this paper, I try to fill this gap by studying voting cohesion from 1980 until 2011 on issues of both ‘high’ politics (security) and ‘low’ politics (human rights) not only as regards EU-US voting cohesion, but also concerning voting cohesion among EU member states. I test six hypotheses derived from International Relations theories, and I argue that EU-US voting cohesion is best explained by the topic of the issue voted upon, whether an issue is marked as ‘important’ by the US government, and by the type of resolution. On the EU level, the length of Union membership and transaction costs matter most.

Recent Changes in European Welfare State Services: A Comparison of Child Care Politics in the U.K., Sweden, Germany, and the Netherlands. CES Germany & Europe Working Papers, No. 07.6, 1997

This paper examines recent policies and politics of services, in particular child care services in European welfare states. It is argued that social (care) services are becoming an increasingly political issue in postindustrial societies and are at the very center of welfare-state restructuring. Some countries have recently developed new policy pro­ grams for child care-but there are important differences among these programs. To understand these differences as well as some common features, the paper argues that it is necessary to examine the institutional organization of child care and short-term political factors as well as the rationales articulated in political debates to support or im­ pede various policies. The paper concludes that a comprehensive system of child care provisions is still far off in most countries, despite a rhetoric of choice and postindustrial care and labor-market patterns.

Urban transportation planning in the U.S.: an historical overview. Final report.

Mode of access: Internet.

Spanish-English bilingual education in the U.S. : current issues, resources, and research priorities /

"An investigation commissioned by the National Institute of Education...completed in 1974."

Nonimmigrant workers in the U.S. : current trends and future implications /

Includes bibliographies.

Workshops on technological change in the U.S. automobile industry October 1977 through April 1978 and the symposium on technology, government and the automotive future, October 19-20, 1978. Proceedings. Final report.

National Highway Traffic Safety Administration, Office of Research and Development, Washington, D.C.

A select bibliography of the history of the Catholic church in the United States.

Mode of access: Internet.