for Hispanics. Clearly the uninsured are the ones to whom larger spending is assigned, and Hispanics have a high probability of being uninsured. These findings indicate that, without the health insurance adjustment, implementing the provisions of health care reform would register that people are worse off with this economic poverty measure.

Considering the pros and cons, Short expressed the view that one would not want to make this adjustment because it would be inconsistent with other elements of the SPM, because everything else in the SPM is based on out-of-pocket spending.

The uninsured who become insured are recorded to be worse off economically because they are now spending more than they were spending before. Because increased spending is compared with the same income, without making this adjustment, the rates indicate that, with health care reform and health insurance coverage, people are recorded as worse off.

She ended with the comment that a complementary measure is needed that shows they are better off in the domain of health care with health insurance coverage. The medical care risk measure might fill that need.

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