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ARTICLE |

Uninsured Children and National Health Reform FREE

M. Susan Marquis, PhD; Stephen H. Long, PhD
[+] Author Affiliations

Any views expressed herein are the authors' and do not necessarily represent those of RAND or its sponsors.

Reprint requests to RAND, 2100 M St NW, Washington, DC 20037-1270 (Dr Marquis).


JAMA. 1992;268(24):3473-3477. doi:10.1001/jama.1992.03490240081042
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THE HEALTH of the nation's children and their access to care has received renewed public policy attention in recent years. A special policy focus on children derives in part from evidence of the cost-effectiveness of preventive and primary care for children.1 However, lack of health insurance poses a significant financial barrier to the receipt of the recommended levels of preventive care, especially for poor children. An increase in the share of the cost of health care the family has to pay out-of-pocket is associated with a decrease in immunizations for all children less than age 7 years and a decrease in the likelihood of having a general medical examination and a vision examination among poor children.2,3 Increased patient cost-sharing also deters poor families from seeking ambulatory care for children for acute problems for which medical advice is highly effective, such as otitis media, "strep throat," lacerations, and fractures.3

REFERENCES

White CC, Koplan JP, Ornstein WA.  Benefits, risks, and costs of immunizations for measles, mumps, and rubella. Am J Public Health . 1985;;75: 739-744.
Lillard L, Manning W, Peterson C, Lurie N, Goldberg G, Phelps C. Preventive Medical Care: Standards, Usage, and Efficacy . Santa Monica, Calif: RAND Corp; 1986;:R-3266-HCFA.
Lohr KN, Brook RH, Kamberg CJ, et al.  Use of medical care in the RAND Health Insurance Experiment. Med Care . 1986;;24( (suppl) ):S1-S87.
Sardell A.  Child health policy in the US: the paradox of consensus. J Health Polit Policy Law . 1990;;15:271-304.
National Governor's Association. A Healthy America: The Challenge for the States . Washington, DC: National Governor's Association; 1991;.
Friedman E.  The uninsured: from dilemma to crisis. JAMA . 1991;;265:2491-2495.
Health Insurance Association of America. Providing Employee Health Benefits: How Firms Differ . Washington, DC: Health Insurance Association of America; 1990;.
Long SH, Marquis MS.  Gaps in employment-based insurance: lack of supply or lack of demand?  In: Health Benefits and the Workforce . Washington, DC: US Government Printing Office; 1992;: 37-42.
Leibowitz A, Chernew M.  The firm's demand for health insurance.  In: Health Benefits and the Workforce . Washington, DC: US Government Printing Office; 1992;:77-83.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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White CC, Koplan JP, Ornstein WA.  Benefits, risks, and costs of immunizations for measles, mumps, and rubella. Am J Public Health . 1985;;75: 739-744.
Lillard L, Manning W, Peterson C, Lurie N, Goldberg G, Phelps C. Preventive Medical Care: Standards, Usage, and Efficacy . Santa Monica, Calif: RAND Corp; 1986;:R-3266-HCFA.
Lohr KN, Brook RH, Kamberg CJ, et al.  Use of medical care in the RAND Health Insurance Experiment. Med Care . 1986;;24( (suppl) ):S1-S87.
Sardell A.  Child health policy in the US: the paradox of consensus. J Health Polit Policy Law . 1990;;15:271-304.
National Governor's Association. A Healthy America: The Challenge for the States . Washington, DC: National Governor's Association; 1991;.
Friedman E.  The uninsured: from dilemma to crisis. JAMA . 1991;;265:2491-2495.
Health Insurance Association of America. Providing Employee Health Benefits: How Firms Differ . Washington, DC: Health Insurance Association of America; 1990;.
Long SH, Marquis MS.  Gaps in employment-based insurance: lack of supply or lack of demand?  In: Health Benefits and the Workforce . Washington, DC: US Government Printing Office; 1992;: 37-42.
Leibowitz A, Chernew M.  The firm's demand for health insurance.  In: Health Benefits and the Workforce . Washington, DC: US Government Printing Office; 1992;:77-83.
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