| Many health policy initiatives focus on providing health insurance to the uninsured, hoping that access to medical care will improve. This research estimates the impact that health insurance has on various types of medical visits.;1,997 respondents aged 18 to 64, diagnosed with asthma, diabetes, or hypertension prior to the study period and who were privately insured or uninsured for the entire study period were selected. Total service volumes were calculated for physician office, hospital outpatient, hospital admissions, hospital length of stay, and prescription drug use. Descriptive and non-parametric analyses were conducted. Endogenous switch Poisson regression was used to address issues of count data and an endogenous predictor.;Health insurance had no effect on emergency room use or hospital admissions. Insurance was linked to use of physician office visits, prescription medications, shorter hospital stays, and hospital outpatient services. Health status and having a usual source of care were significant factors. Racial disparities and regional variation were observed.;Insurance has little effect on the volume of acute care services consumed. As acuity increases, demand becomes more inelastic and cost becomes less of a factor in the decision to consume. The results suggest that a compulsory, basic coverage plan for all with optional supplemental coverage is a viable reform option. Policy should promote regular care sites and the importance of income stabilization, education, and housing policy as complementary tools to improve public health. |
