ok - NBER WORKING PAPER SERIES COVERING THE UNINSURED IN...

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NBER WORKING PAPER SERIES COVERING THE UNINSURED IN THE U.S. Jonathan Gruber Working Paper 13758 http://www.nber.org/papers/w13758 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts Avenue Cambridge, MA 02138 January 2008 Paper prepared for Journal of Economic Literature. I am grateful to Bert Lue, David Ovadia and Janet Zhou for excellent research assistance, to the Kaiser Family Foundation for funding, and to Roger Gordon and the referees for very helpful comments. The views expressed herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of Economic Research. © 2008 by Jonathan Gruber. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source.
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Covering the Uninsured in the U.S. Jonathan Gruber NBER Working Paper No. 13758 January 2008 JEL No. H1,I1 ABSTRACT One of the major social policy issues facing the U.S. in the first decade of the 21st century is the large number of Americans lacking health insurance. This article surveys the major economic issues around covering the uninsured. I review the facts on insurance coverage and the nature of the uninsured; focus on explanations for why the U.S. has such a large, and growing, uninsured population; and discuss why we should care if individuals are uninsured. I then focus on policy options to address the problem of the uninsured, beginning with a discussion of the key issues and available evidence, and then turning to estimates from a micro-simulation model of the impact of alternative interventions to increase insurance coverage. Jonathan Gruber MIT Department of Economics E52-355 50 Memorial Drive Cambridge, MA 02142-1347 and NBER gruberj@mit.edu
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One of the major social policy issues facing the U.S. in the first decade of the 21 st century is the large number of Americans lacking health insurance. While other industrialized nations guarantee universal health care for their citizens, in the U.S. 47 million persons, or 18% of the non-elderly population (the elderly are universally covered under the Medicare program) lack health insurance. As a result, the problem of the uninsured has been front and center in public policy debates and political campaigns for many years. The (failed) centerpiece of the early Clinton presidency was a plan for universal health coverage; 15 years later, each of the major Democratic candidates for President is proposing a plan for universal health coverage. Of course, health insurance is not the only “merit” good which is not universally consumed by the American public: a larger number of U.S. households do not own their own homes, for example, than the number of households that contain uninsured individuals. While homeownership is viewed as a valid goal for families, there is little demand for universal ownership. With health insurance, however, a number of arguments are used to justify universal
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ok - NBER WORKING PAPER SERIES COVERING THE UNINSURED IN...

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