(2) resources, and (3) the type of insurance to estimate financial exposure. With such information, as a companion to the SPM and consistent with the measure of medical care economic burden, a measure of medical care economic risk could be calculated for families (and unrelated individuals), as defined in the SPM.10

As with metrics to assess burden, a measure of medical care economic risk could be used either in conjunction with an absolute standard, such as a poverty measure, or with a relative standard, with thresholds that vary by poverty-income groups. A difference in approaches is that a measure of medical care economic risk would not necessarily have to take premiums into account, as premiums could be treated as regular recurring expenses.

Ideally, a measure of medical care economic risk would also provide information on the gains in welfare from having insurance that ensures access to essential care and that protects against economic risk when sick, at a premium cost that is affordable relative to income. For example, it could capture the extent to which patterns of care shift away from admissions to the hospital for potentially preventable complications of chronic disease or indicators of receipt of care, such as preventive dental care and early detection and treatment of cancer, that can improve quality of life and potentially avoid premature death.


10 The SPM expands the family concept used in the official poverty measure to include same-sex spouses, unmarried partners, foster children, and other unrelated children. The expanded family is designed to match or at least better approximate the family unit used in the Consumer Expenditure Survey, which is the data source for the SPM poverty thresholds (Provencher, 2011).

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