Perspectives on health care: United States, 1980

The National Medical Care Expenditure Survey (NMCUES) was designed to address numerous policy issues concerning costs of medical care, sources of payment, and access to care. Special emphasis is given in this volume to Medicare and Medicaid beneficiaries and the role of these programs as payors for health care. Among the findings presented here a few deserve special attention. These are grouped under the areas of coverage, utilization, and expenditures and are briefly outlined in the following. Coverage--Medicaid covers about half of the noninstitutionalized population living below the poverty level. Coverage is higher among poor children; 60 percent of those under age 6 have Medicaid coverage. Medicaid coverage is higher among black people (30 percent) and Hispanics (19 percent), groups with more low income people and people in poor health, than among white people (8 percent). Medicaid eligibles in all aid categories are in poorer health than others of their age; twice the percent of Aid to Families With Dependent Children eligibles report their health as fair or poor, compared with 18-44 years of age. A higher percentage of Medicaid eligibles have activity and functional limitations at all ages. Although high among all age groups, use of health services is highest among the elderly. Almost two-thirds report their health status as excellent or good. Among those with private insurance in addition to Medicare, over 80 percent saw a doctor at least once in a year and over 75 percent took at least one prescribed drug. About a fifth of those 65-74 years of age, and fewer than a third of those 75 years or over, were hospitalized in 1980. About two-thirds of aged Medicare beneficiaries had some type of private supplementary health insurance. The uninsured are likely to be young (19-24 years of age). Among black people, however, those 45-64 years of age are as likely to be uninsured (14.3 percent) as those 19-24 years of age (12.6 percent). The uninsured are likely to be poor (below poverty level) or near poor (under one and a half times the poverty level) as well. A quarter of the poor and near poor with full-time employment were uninsured, compared to 6 percent of higher income persons employed full time. Utilization--Medicare and Medicaid substantially improved access to care among their beneficiaries.(ABSTRACT TRUNCATED AT 400 WORDS)