title: Spillovers and vulnerability: the case of community uninsurance.
abstract: This paper studies the uninsured as a vulnerable population. We contend that reducing the size of the uninsured population yields important spillover benefits to the insured population, benefits that go beyond a lower charity care burden. Evidence presented in this paper reinforces studies in the literature that show that problems of health services quality and access facing insured people increase when the proportion of uninsured people in their local communities is greater. The size of such spillover benefits is reduced if the local market is large enough to be segmented based on insurance status.
authors.affiliation: Department of Health Care Systems, Wharton School, University of Pennsylvania, Philadelphia, PA, USA. pauly@wharton.upenn.edu
authors.forename: Mark V
authors.initials: MV
authors.lastname: Pauly
authors.forename: José A
authors.initials: JA
authors.lastname: Pagán
mesh_terms: D001294:Attitude to Health; D018672:Community Health Planning; D003153:Community Health Services / Q000191:economics / Q000600:supply & distribution*; D019981:Health Care Sector / Q000639:trends*; D006297:Health Services Accessibility / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000639:trends*; D012111:Residence Characteristics; D014481:United States; D035862:Vulnerable Populations / Q000706:statistics & numerical data*