Hospital Care for the Uninsured in Miami-Dade County: Hospital Finance and Patient Travel Patterns

By Catherine A. Jackson; Kathryn Pitkin Derose et al. | Go to book overview
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Chapter Two
BACKGROUND

THE PROBLEM

According to the 1999 Florida Health Insurance Study (FHIS), 24.6 percent of the nonelderly population of Miami-Dade County—nearly one-half million persons—are uninsured.1 This is well above the national average of 16 percent,2 ranking fourth among selected metropolitan areas (MSAs)(see Table 2.1).3 Within Florida itself, MiamiDade's uninsured rate is exceeded only by that of the rural midstate counties4 (25.5 percent for those counties, taken together). Lack of health insurance is disproportionately high among ethnic minorities in Miami-Dade (see Figure 2.1) and thus also among immigrants, most of whom are ethnic minorities.

People with lower incomes in Miami-Dade are also less likely to have health insurance. The FHIS found that nearly one-third of those with incomes of less than 150 percent of the federal poverty level (FPL) lacked health insurance. In stark contrast, less than 20 percent of those with family incomes between 200 and 250 percent of the FPL lack health insurance, and less than 10 percent of those with family incomes over 250 percent of the FPL are uninsured. This supports

____________________
1
Agency for Health Care Administration (AHCA) (2000).
2
Moyer (1999).
3
The MSAs were selected to be comparable to Miami—that is, they were either in Florida or had significant Hispanic populations.
4
De Soto, Glades, Hardee, Hendry, Highlands, Monroe, and Okeechobee Counties (Florida Health Insurance Study, AHCA, 2000).

-3-

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