Accounting for the burden and redistribution of health care costs: Who uses care and who pays for it. (27th January 2020)

• Record Type: Journal Article
• Authors: Carman, Katherine Grace; Liu, Jodi; White, Chapin
• Is Part Of: Health services research. Volume 55:Number 2(2020)
• Page Start: 224
• Page End: 231
• Publication Date: 2020-01-27
• Subjects: health care costs -- health care financing -- health economics -- redistribution; Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.13258
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract: Objective: To measure the burden of financing health care costs and quantify redistribution among population groups. Data Sources: A synthetic population using data combined from multiple sources, including the Survey of Income and Program Participation (SIPP), Medical Expenditure Panel Survey (MEPS), Kaiser Family Foundation (KFF)/Health Research Educational Trust (HRET) Employer Health Benefits Survey, American Community Survey (ACS), and National Health Expenditure Accounts (NHEA). Study Design: We estimate two dollar amounts for each individual in the synthetic population: (a) payments to finance health care services, which includes all payments by a household and their employers to finance health care, including premiums, out‐of‐pocket payments, federal and state taxes, and other payments; and (b) the dollar value of health care services received, which equals the amount paid to providers for those services. Data Extraction Methods: We linked the nationally representative survey data using statistical matching. We allocated health care expenditures from the NHEA to individuals and households based on expenditures reported in the MEPS. Principal Findings: We show that higher‐income households pay the most to finance health care in dollar amounts, but the burden of payments as a share of income is greater among lower‐income households. Conclusions: Accounting for all sources of payments provides a clear picture of the burden of financing health care costs, and how that burden is spread under our current financing system.