title: Catastrophic health insurance and HMO's.
abstract: The catastrophic health insurance bills introduced during the 96th U.S. Congress failed to consider the current role that Health Maintenance Organizations (HMO's) play in providing catastrophic protection and the potential negative impact such legislation may have on their competitive position. This article demonstrates that HMO's are providing this coverage by using the simulated health care expenditures for families in one HMO. The estimated proportion of families that incur catastrophic expenditures varies from 0.3 to 14.4% depending on the definition used for catastrophic. The paper closes with a discussion of the potential adverse impact that the legislation would have had on HMO's.
mesh_terms: D000293:Adolescent; D000368:Aged; D002388:Catastrophic Illness / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D004465:Economic Competition; D004467:Economics; D005190:Family; D005260:Female; D005102:Health Expenditures; D006279:Health Maintenance Organizations / Q000191:economics*; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D007354:Insurance, Major Medical / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D014481:United States