Informing American Health Care Policy: The Dynamics of Medical Expenditure

In 1977 the average American spent $755 per year on health care, most physicians functioned as independent practitioners, and only 5.6 million people under the age of 65 were enrolled in HMOs. Twenty years later, per capita expenditures had more than tripled, most physicians practiced within a manag [...]
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In 1977 the average American spent $755 per year on health care, most physicians functioned as independent practitioners, and only 5.6 million people under the age of 65 were enrolled in HMOs. Twenty years later, per capita expenditures had more than tripled, most physicians practiced within a managed care environment, and HMO enrollment stood at 62 million. Keeping pace with these and other changes in the U.S. health system has been the job of the National Medical Expenditure Surveys (NMES). Since they were first started in the 1970s, these federal government surveys have defined our basic understanding of how individuals and families use and pay for America's health care systems and have directly influenced national policy changes, health care reform, and cost-control strategies. Informing American Health Care Policy is the definitive resource that analyzes the overall effect of the National Medical Expenditure Surveys. This important edited collection is written by an outstanding panel of experts from a variety of disciplines and includes contributions from nationally known economists, sociologists, and survey researchers. Rich in insights and lessons learned, Informing American Health Care Policy
Offers a critical assessment and a discerning overview of NMES' outcomes
Describes how the design strategies and methods evolved over the past two decades
Provides a detailed discussion about the collection of a wide range of data on health insurance and employment status
Addresses troublesome issues in defining and measuring access in vulnerable populations
Summarizes the multiple and complex issues of survey design, population sampling, and analytical method
Demonstrates the indispensability of NMES data in the health reform debates The contributors examine how the current health care environment reflects the successes and failures of previous research and makes recommendations on how to adapt survey research to be more effective in the future. The Important Lessons Learned from the National Medical Expenditure Surveys Informing American Health Care Policy provides a critical perspective on the National Medical Expenditure Surveys (NMES) and how these surveys have responded to the sometimes conflicting challenges of policy and research. Sponsored by the Agency for Health Care Policy and Research and written by a stellar panel of interdisciplinary experts including contributions from nationally known economists, sociologists, and survey researchers, this essential resource is filled with lessons learned and emerging strategies for the future. "I enjoyed reading this book. Thanks to the major investment in health expenditure and insurance surveys and the increasingly sophisticated analytic capacity described in this volume, policy officials now have a much more precise and up-to-date understanding of the implications of policy choices."--Karen Davis, president, The Commonwealth Fund; developed President Carter's 1977 national health reform proposal "In this important book, the lead researchers associated with NMES describe the development of this rich data source and, in a series of well-crafted papers, illustrate the use of these data in informing major areas of health policy. It is a must read for anyone interested in American health policy-especially for younger professionals entering this growing field."--Uwe E. Reinhardt, James Madison Professor of Political Economy, Princeton University "National health expenditure surveys have provided policymakers with the information they need to make informed decisions. This volume tells us about the evolution and contributions of the federal government's most ambitious health care survey. I recommend it for those interested in improving the quality of data available to those who formulate policy."--John K. Iglehart, founding editor, Health Affairs "Thoughtful and informed reflections on the lessons learned by NMES. Provides sound guidance and procedures required to address the enduring policy questions of Who's covered? Who pays?, and How much? in the emerging U.S. health care environment of the future."--Lu Ann Aday, professor of behavioral sciences and management and policy sciences, the University of Texas School of Public Health; and author, Designing and Conducting Health Surveys, Fourth Edition