expertise in the measurement of poverty and the financial burden of health care. One responsibility of the coordinating group could be to produce a report accompanying the release of the annual MCER measure that raises any data, methodological, or policy issues relevant to the measure.


The panel has made specific recommendations regarding which data sets should be used for measures of medical care economic burden and risk. These recommendations address data sets currently collected by either HHS or the Census Bureau.

Recommendation 6-3: The panel recommends that funding for the current data collection efforts be maintained at a level to ensure that rigorous, accurate calculations of measures of medical care economic burden and risk can be made.

As pointed out in Chapter 1, one substantial deficiency in the calculation of a measure of medical care economic risk is the lack of information available about people who enter institutional care, such as nursing homes. Because the CPS does not collect data on these populations, they are excluded from the universe for both the official poverty measure and the SPM. This presents a particularly significant limitation for the measurement of prospective risk in that one must exclude what is, for many elderly, their biggest health-related economic risk. This problem may have a solution in the future given ongoing advances in data collection, adoption of electronic medical records, and the linking of surveys with administrative data. The panel’s recommendations are based on the current collection of available federal data sources. However, new and better data will become available in future years. The panel urges that these new data sources be evaluated as they become available to determine if their use would produce a more accurate measure. An appropriate role for the interagency coordinating group could be the assessment of these new data sources.


The panel has proposed a methodological approach to calculating a measure of MCER (as well as the more easily calculated measure of burden), that we think will provide the most accurate information available. However, we are not so presumptuous as to assume that we have answered every design question correctly. Further methodological work will be necessary. In many ways, the deliberations of this panel have raised as many questions as they have answered. For example, the use of assets to offset

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