News Release

New book sheds light on U.S. health insurance crisis.

February 12, 2004 press release from the University of Michigan News Service and School of Public Health.

ANN ARBOR, Mich.— Catherine McLaughlin believes that a lack of consensus among researchers helped doom the push for national health coverage a decade ago.

Policymakers couldn't get a cohesive sense of which Americans lacked coverage and why, nor how many would be covered under different scenarios much less how much it would cost, because of a lack of clear research on the issues, she said.

Both then and now, myths tend to be taken as facts---beliefs like "universal coverage by itself would eliminate health disparities" and "a worker's decision to remain uninsured has no effect on anyone else," said McLaughlin, director of the Economic Research Initiative on the Uninsured (ERIU) and professor of health management and policy at the UM School of Public Health.

The initiative is a University of Michigan-based research effort working to examine the issues of the uninsured through rigorous economic analysis. In its third year of a $9 million grant from the Robert Wood Johnson Foundation, ERIU recently launched a book today outlining ERIU-commissioned research on what is known and what is unknown about the uninsured.

McLaughlin and a panel of ERIU participants presented top-10 myths about the uninsured at a book launch event February 9 at the National Press Club in Washington, D.C. Attended by approximately 100 policy analysts, policymakers, and members of the media, the event was hosted by the Urban Institute Press, publishers of the new ERIU book, Health Policy and the Uninsured.

Among the topics addressed in the book are:

--Who lacks health insurance in the U.S. This discussion includes an examination of continuous and sporadic coverage to try to understand who is always with or without insurance and who is sometimes without insurance. More than half of the newly uninsured regain coverage within six months, while others go without for more than five years, a distinction missed by the most commonly used data sets measuring the uninsured.

--Why people do not have health insurance. The book looks at the many reasons people lack coverage, including people who do not buy insurance because they do not think they need it and people who want coverage but cannot get it because of insurance underwriting practices or the labor market.

--How the labor market factors in to insurance issues. Though health insurance matters in people's decisions to retire or change jobs, very little research has been done to determine the extent to which people choose particular jobs or industries because of coverage availability or the extent to which they are afraid to change jobs because of fear of losing coverage. Also the book examines why part-time jobs rarely offer insurance.

--How lack of insurance affects health status. The book points out that very few controlled studies exist that allow detailed analysis of a causal relationship between health insurance and health status. Further research is necessary to understand for which individuals the lack of insurance is a primary cause of poor health. For many individuals, more important determinants of health are socioeconomic status or chronic disease status.

McLaughlin has studied various health economics topics since joining the UM faculty in 1983. Her current research interests are focused on the uninsured, managed care, market competition, and employer and employee benefit choice.

U-M's Economic Research Initiative on the Uninsured: http://www.umich.edu/eriu

For more about McLaughlin: http://www.sph.umich.edu/iscr/faculty/profile.cfm?uniqname=cmcl

More information on Wednesday's book launch: http://www.urban.org/conferences/uninsured/

For details on "Health Policy and the Uninsured"
http://www.uipress.org/Template.cfm?Section=Bookstore&template=/Ecommerce/ProductDisplay.cfm&ProductID=4380

Contact : Colleen Newvine
Phone: (734) 647-4411
E-mail: cnewvine@umich.edu