PUBLIC RESPONSIBILITY AND INEQUALITY IN HEALTH INSURANCE COVERAGE: AN EXAMINATION OF AMERICAN STATE HEALTH CARE SYSTEMS

• 成果类型: Article
• 署名作者: Zhu, Ling; Johansen, Morgen
• 署名单位: University of Houston System; University of Houston; University of Hawaii System; University of Hawaii System
• 刊物名称: PUBLIC ADMINISTRATION
• ISSN/ISSBN: 0033-3298
• DOI: 10.1111/padm.12083
• 发表日期: 2014
• 页码: 422-439
• 关键词: for-profit; organizational performance; dimensions; nonprofit; Hospitals

摘要

This article examines the effect of the three publicness dimensions on inequality in health insurance coverage across 50 American state-level health care systems. The analysis validates a Gini-coefficient measure of Americans' unequal distribution of health insurance coverage across nine income groups and compares public ownership, financing, and control of health care systems across all 50 states from 2002 to 2010. There is a significant and negative relationship between public ownership and inequality in health insurance coverage, although the substantive impact of ownership is relatively small. Both public financing and control substantially reduce inequality in health insurance coverage across income groups. However, both of these must be present in order to be effective at reducing inequality. This article expands our understanding of the link between different institutional arrangements and inequality in health insurance coverage in hybrid health care systems.