Economic Research Initiative on the Uninsured launches book

ANN ARBOR—Catherine McLaughlin believes that a lack of consensus among reseachers helped doom the push for national health coverage a decade ago.

Policy makers couldn’t get a cohesive sense of which Americans lacked coverage and why, nor how many would be covered under different scenarios much less how much it would cost, because of a lack of clear research on the issues, she said.

Both then and now, myths tend to be taken as facts—beliefs like "universal coverage by itself would eliminate health disparities" and " a worker’s decision to remain uninsured has no effect on anyone else," said McLaughlin, director of the Economic Research Initiative on the Uninsured (ERIU) and professor of health management and policy at the U-M School of Public Health.

The initiative is a University of Michigan-based research effort working to examine the issues of the uninsured through rigorous economic analysis. In its third year of a $9 million grant from the Robert Wood Johnson Foundation, ERIU is launching a book today outlining ERIU-commissioned research on what is known and what is unknown about the uninsured.

McLaughlin and a panel of ERIU participants will present top 10 myths about the uninsured at a book launch event Wednesday (Feb. 11) at the National Press Club in Washington, D.C. The event is hosted by the Urban Institute Press, publishers of the new ERIU book "Health Policy and the Uninsured."

Among the topics addressed in the book are:

• Who lacks health insurance in the U.S. This discussion includes an examination of continuous and sporadic coverage to try to understand who is always with or without insurance and who is sometimes without insurance. More than half of the newly uninsured regain coverage within six months, while others go without for more than five years, a distinction missed by the most commonly used data sets measuring the uninsured.

• Why people do not have health insurance. The book looks at the many reasons people lack coverage, including people who do not buy insurance because they do not think they need it and people who want coverage but cannot get it because of insurance underwriting practices or the labor market.

• How the labor market factors in to insurance issues. Though health insurance matters in people’s decisions to retire or change jobs, very little research has been done to determine the extent to which people choose particular jobs or industries because of coverage availability or the extent to which they are afraid to change jobs because of fear of losing coverage. Also the book examines why part-time jobs rarely offer insurance.

• How lack of insurance affects health status. The book points out that very few controlled studies exist that allow detailed analysis of a causal relationship between health insurance and health status.  Further research is necessary to understand for which individuals the lack of insurance is a primary cause of poor health.  For many individuals, more important determinants of health are socioeconomic status or chronic disease status.

McLaughlin has studied various health economics topics since joining the U-M faculty in 1983. Her current research interests are focused on the uninsured, managed care, market competition, and employer and employee benefit choice.

Related links:

U-M’s Economic Research Initiative on the Uninsured >

For more about McLaughlin >

More information on Wednesday’s book launch > Details on "Health Policy and the Uninsured" >