Social Insurance and Public Assistance

More documents

Recommendations

Info

834 Series Bf875–886 Bf SOCIAL INSURANCE AND PUBLIC ASSISTANCE TABLE Bf875–886 Health care expenditures, by source of funds: 1960—1997 Continued Counting the cost of the premiums and the benefits that are paid by the insurer would overstate the funding received by the provider of care. Similarly, coinsurance and deductible amounts paid by supplementary medigap policies are excluded. For most services, out-of-pocket spending estimates for 1980 through 1989 are based on information from the consumer expenditure (CE) survey conducted by the Department of Labor. Sources other than the CE are used for other categories. Surveys of the non-institutional population’s health care use and financing patterns have been conducted periodically over the past three decades. For 1963 and 1970, the Center for Health Administration Studies and the National Opinion Research Center, both at the University of Chicago, surveyed individuals for the purpose of providing “reliable and valid statistics of medical care use and expenditures for . . . public policy and research activities” (Research Triangle Institute, Benchmark Studies of the National Health Accounts, HCFA contract number 500-86-0042, prepared for the Health Care Financing Administration, March 1987). These studies were followed in 1977 by the National Medical Care Expenditure Survey (National Center for Health Services Research, Department of Health and Human Services: Data from the National Medical Care and Utilization Survey (1977)) and in 1980 by the National Medical Care and Utilization Survey (National Center for Health Statistics, Department of Health and Human Services: Data from the National Medical Care Utilization and Expenditure Survey (1980)). (Expenditure information from the national medical expenditure survey covering 1987 recently became available. Data from this source will be integrated into the NHA during the next benchmark revision.) These surveys have provided information used to determine the amount of out-of-pocket spending in historical periods. At the NHE level, private health insurance expenditures equal the premiums earned by private health insurers. This figure is decomposed to benefits incurred (personal health care expenditures) and net cost, the difference between premiums and benefits. In addition to the traditional insurers such as commercial carriers and Blue Cross and Blue Shield, the NHA category for private health insurance includes a number of other plans. Health maintenance organizations are included here, as are self-insured plans. Estimates of private health insurance benefits by type of service were developed in conjunction with out-of-pocket spending. Both relied on periodic historical surveys to determine the relative share of private health insurance and outof-pocket spending. Surveys by medical trade associations, the Visiting Nurse Association, and the federal government augmented the person survey data. Estimates of total premiums earned by private health insurers are derived from the data series on the financial experience of private health insurance organizations compiled and analyzed by the Health Care Financing Administration (HCFA) (R. H. Arnett and G. Trapnell, “Private Health Insurance: New Measures of a Complex and Changing Industry. Health Care Financing Review 6 (2) (1984)). Data for these estimates are furnished by the Health Insurance Association of America, the National Underwriter Company, Blue Cross and Blue Shield Association, Group Health Association of America, and a survey of self-insured and prepaid health plans conducted by HCFA. These estimates are verified using the Bureau of Labor Statistics (1980–1990) employment cost index and CE survey. Estimates of Medicare spending for health services and supplies are based on information received from Medicare actuaries, reports submitted by Medicare contractors, and administrative and statistical records. Medicaid estimates are based primarily on financial information reports filed by the state Medicaid agencies on Form HCFA-64. These reports provide total program expenditures and service distributions. Prior to the availability of the Form HCFA-64 in 1979, state statistical reports (Form HCFA-2082) were used to develop service distributions. The federal share of Medicaid spending was taken from federal budget outlay data (Executive Office of the President, 1960–1991; Bureau of Government Financial Operations, 1960–1991) For further information, see the Center for Medicare and Medicaid Services Web site. Several adjustments to reported program data are necessary to fit the estimates into the framework of the NHA. An estimate of Medicaid buy-ins to Medicare is deducted to avoid double counting when the programs are presented together. An estimate of hospital-based home health care spending is added to hospital care expenditures and subtracted from home health care expenditures. That portion of reported program expenditures for intermediate care facilities for the mentally retarded estimated to cover services in hospital-based facilities (40 percent of the total) is counted as hospital care rather than nursing home care. All health care expenditures that are channeled through any program established by public law are treated as a public expenditure in the NHA. For example, expenditures under workers’ compensation programs are included with government expenditures, even though they involve benefits paid by insurers from premiums that have been collected from private sources. Similarly, premiums paid by enrollees for Medicare SMI are treated as public, rather than private, expenditure because payment of benefits is made by a public program. However, Medicare coinsurance and deductibles are included under out-of-pocket payments because they are paid directly by the beneficiary to the provider of service. To be included in the NHA, a program must have provision of care or treatment of disease as its primary focus. For this reason, nutrition, sanitation, and antipollution programs are excluded. Another example of this is “Meals on Wheels,” which is excluded from the NHA because it is viewed as a nutrition program rather than a health service program. Statistics on federal program expenditures are based, in part, on data reported by the budget offices of federal agencies. Several differences exist from spending reported in the federal budget because of the conceptual framework on which the NHA are based. Series Bf875. The sum of series Bf876 and Bf881. Series Bf876. The sum of series Bf878–880. Series Bf881. The sum of series Bf882–883. It is also the sum of series Bf884–886.
PRIVATE WELFARE Series Bf887–892 835 TABLE Bf887–892 Private health insurance – persons insured, by type of insurer: 1940–1995 Contributed by Price V. Fishback and Melissa A. Thomasson By insurance companies Blue Cross Group Individual/family and Blue Total Total policies policies Shield plans Other plans Bf887 Bf888 Bf889 Bf890 Bf891 Bf892 Year Million Million Million Million Million Million 1940 12.0 3.7 2.5 1.2 6.0 2.3 1945 32.0 10.5 7.8 2.7 18.9 2.7 1950 76.6 37.0 22.3 17.3 38.8 4.4 1955 101.4 53.5 38.6 19.9 50.7 6.5 1960 122.5 69.2 54.4 22.2 58.1 6.0 1961 125.8 70.4 56.1 22.4 58.7 7.1 1962 129.4 72.2 58.1 23.1 60.1 6.9 1963 133.5 74.5 61.5 23.5 61.0 7.2 1964 136.3 75.8 63.1 34.0 62.1 6.8 1965 138.7 77.6 65.4 24.4 63.3 7.0 1966 142.4 80.4 67.8 24.9 54.3 6.6 1967 146.4 82.6 71.5 24.6 67.2 7.1 1968 151.9 85.7 74.1 25.3 70.1 7.3 1969 155.0 88.8 77.9 25.9 82.7 7.7 1970 158.8 89.7 80.5 26.7 85.1 8.1 1971 161.8 91.5 80.6 27.8 76.5 8.5 1972 164.1 93.7 81.5 29.1 78.2 8.1 1973 168.5 94.5 83.6 27.5 81.3 9.6 1974 173.1 97.0 85.4 28.8 83.8 11.1 1975 178.2 99.5 87.2 30.1 86.4 13.1 1976 176.9 97.0 86.8 27.0 86.6 14.9 1977 179.9 100.4 89.2 28.7 86.0 18.1 1978 185.7 106.0 92.5 36.1 85.8 21.5 1979 185.7 104.1 94.1 34.4 86.1 25.5 1980 187.4 105.5 97.4 33.8 86.7 33.2 1981 186.2 105.9 103.0 25.3 85.8 40.3 1982 188.3 109.6 103.9 29.4 82.0 48.2 1983 186.6 105.9 104.6 22.2 79.6 53.6 1984 184.4 103.1 103.0 20.4 79.4 54.4 1985 181.3 100.4 99.5 21.2 78.7 55.1 1986 180.9 98.2 106.6 12.1 78.0 64.9 1987 1 179.7 96.7 106.1 10.4 76.9 66.9 1988 1 182.3 92.6 100.5 10.7 74.0 71.3 1989 2 182.5 88.9 98.7 10.0 72.5 78.6 1990 2 181.7 83.1 88.7 10.2 70.9 86.2 1991 181.0 78.0 83.3 9.9 68.1 93.5 1992 180.7 76.6 82.1 8.5 67.5 97.9 1993 180.9 74.7 80.9 7.4 65.9 105.7 1994 182.2 75.8 82.4 7.0 65.2 112.9 1995 185.3 76.6 83.3 7.0 65.6 120.1 1 Revised Health Insurance Association of America survey form. 2 Change in methodology. Source Source Book of Health Insurance Data (1998), Table 2.10, p. 39. Documentation This table reports information collected by the Health Insurance Association of American on the number of privately insured Americans covered through commercial insurance companies, through Blue Cross and Blue Shield plans, and under other types of policies such as health maintenance organizations and other managed care plans. Series Bf887–888. Refers to the net total of persons protected so that duplication among persons protected by more than one insuring organization or more than one policy providing the same type of coverage has been eliminated. Series Bf887. Excludes hospital indemnity coverage that may have been included in prior editions. For 1975 and later, data include the number of persons covered in Puerto Rico and other U.S. territories and possessions.
Page 1 and 2:
CHAPTER Bf Social Insurance and Pub
Page 3 and 4:
PUBLIC ASSISTANCE: COLONIAL TIMES T
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
SOCIAL WELFARE: 1929 TO THE PRESENT
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
POOR RELIEF Series Bf 17-22 721 TAB
Page 31 and 32:
POOR RELIEF Series Bf 23-27 723 TAB
Page 33 and 34:
POOR RELIEF Series Bf 34-149 725 TA
Page 35 and 36:
POOR RELIEF Series Bf 34-149 727 TA
Page 37 and 38:
POOR RELIEF Series Bf 156-175 729 T
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
SOCIAL WELFARE EXPENDITURES Series
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
SOCIAL WELFARE PROGRAMS Series Bf27
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92: SOCIAL WELFARE PROGRAMS Series Bf49
Page 129 and 130: PRIVATE WELFARE Series Bf773-785 82
Page 141: PRIVATE WELFARE Series Bf875-886 83
show all

Social Insurance and Public Assistance

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?