Assessing the Impact of Health Insurance and Other Socioeconomic Factors on Inequality in Health Care Expenditures among Farm Households

By El-Osta, Hisham S. | Agricultural and Resource Economics Review, April 2015 | Go to article overview

Assessing the Impact of Health Insurance and Other Socioeconomic Factors on Inequality in Health Care Expenditures among Farm Households


El-Osta, Hisham S., Agricultural and Resource Economics Review


(ProQuest: ... denotes formulae omitted.)

Annual health care expenditures in the United States in 2011 were nearly $2.7 trillion (see Figure 1), or close to 18 percent of the nation's gross domestic product (GDP) (Centers for Medicare and Medical Services 2012), a significant increase over the $27.4 billion spent in 1960 (5 percent of GDP) and greater than any other industrialized country (Organization for Economic Cooperation and Development (OECD) 2012). On a per capita basis, the 2011 U.S. expenditures average out to about $8,606 per year, up from $147 in 1960. Newhouse (1992) attributed the significant increases to growing demand for health care services and the rising cost of those services caused by accelerated development and use of new medical technologies. Giles (2003) attributed it in large part to structural factors such as insurance contracts and particularly emphasized the share of expenses covered by third parties (e.g., insurance companies, employers, and Medicare). This dramatic increase in both raw spending and share of GDP is a major concern to policymakers because of the likely adverse impact on employment, inflation, and per capita GDP (Office of the Assistant Secretary for Planning and Evaluation 2008).1

Another characteristic of health care expenditures in the United States is wide variation in its distribution. According to Stanton and Rutherford (2005), nearly half of the population (civilian noninstitutionalized) in 2002 spent little or nothing on health care while the top 5 percent in terms of individual expenditures accounted for nearly half of the total amount. This concentration of spending continued throughout the decade. As shown in Figure 2, the top 5 percent in 2009 were once again responsible for nearly half of all spending. Concentration in U.S. health care spending is further demonstrated by the 15 percent of the population with no spending and the lower half of the health care distribution, which accounts for only 3 percent of total spending.

Because they are self-employed and at a relatively high risk of injury and illness due to the nature of their work, farmers are among the most disadvantaged groups in the U.S. economy in terms of health risks (Mishra, El-Osta, and Ahearn 2012).2 Consequently, their decisions about insurance and spending on health care are of particular interest. Figure 2 demonstrates that there is a concentration of spending on health care among farmers (excluding nonfamily corporations and cooperatives) as well, though it is less pronounced. Households representing the top 5 percent of annual health care expenses captured only a little more than one-fifth of all spending. On the low end of the spending distribution, nearly 7 percent of households had no expenditures and 50 percent of the lowest-spending farm household members represented 17 percent of total spending.

As shown in Figure 3, farmers rely more often than the population in general on individual insurance policies purchased directly from insurance providers (Mishra, El-Osta, and Ahearn 2012)-17.1 percent compared to 9.8 percent for the U.S. population as a whole. Farmers are, however, less likely than the general population to lack health insurance altogether (9.3 percent versus 15.7 percent). In addition, a smaller share of farm household members receives health insurance provided by the government through Medicare or Medicaid and about the same share receives coverage through off-farm employers of the operator and/or a spouse.3

The primary objective of this study is to examine the inequality in the distribution of health care expenditures (both for private insurance purchases and out-of-pocket medical expenses) noted for nonelderly farm operators and determine how much of that inequality is explained by privately acquired health insurance. In addition, the study explores the impacts of income positions of farm households, the extent of income inequality among households, socioeconomic factors (such as age, educational attainment, ethnicity, and family structure), and other factors such as farm subsidies on inequality in health care spending. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Assessing the Impact of Health Insurance and Other Socioeconomic Factors on Inequality in Health Care Expenditures among Farm Households
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.