Informing American Health Care Policy : The Dynamics of Medical Expenditure and Insurance Surveys, 1977-1996

In 1977 the average American spent $755 per year on health care, most physicians functioned as indepAndent practitioners, and only 5.6 million people under the age of 65 were enrolled in HMOs. Twenty years later, per capita expAnditures had more than tripled, most physicians practiced within a managed care environment, and HMO enrollment stood at 62 million. Keeping pace with these and other changes in the U.S. health system has been the job of the National Medical ExpAnditure Surveys (NMES). Since they were first started in the 1970s, these federal government surveys have defined our basic understanding of how individuals and families use and pay for America s health care systems and have directly influenced national policy changes, health care reform, and cost control strategies.Informing American Health Care Policy is the definitive resource that analyzes the overall effect of the National Medical ExpAnditure Surveys. This important edited collection is written by an outstanding panel of experts from a variety of disciplines and includes contributions from nationally known economists, sociologists, and survey researchers. Rich in insights and lessons learned, Informing American Health Care Policy? Offers a critical assessment and a discerning overview of NMES outcomes? Describes how the design strategies and methods evolved over the past two decades? Provides a detailed discussion about the collection of a wide range of data on health insurance and employment status? Addresses troublesome issues in defining and measuring access in vulnerable populations? Summarizes the multiple and complex issues of survey design, population sampling, and analytical method? Demonstrates the indispensability of NMES data in the health reform debatesThe contributors examine how the current health care environment reflects the successes and failures of previous research and makes recommAndations on how to adapt survey research to be more effective in the