Garnick D W, Hendricks A M, Thorpe K E, Newhouse J P, Donelan K, Blendon R J
Institute for Health Policy, Heller School, Brandeis University, Waltham, MA.
Health Aff (Millwood). 1993 Fall;12(3):204-12. doi: 10.1377/hlthaff.12.3.204.
Data from two surveys are used in this DataWatch to explore Americans' understanding of their health insurance. First, data from a national survey of consumers are used to examine if people with private health insurance correctly report their coverage for six services. Second, information from an evaluation of a pilot project of subsidized insurance in New York is used to investigate how well newly insured persons understand their coverage. Based on these surveys, almost all privately insured people understand the basic elements of their insurance plans but underestimate their coverage for mental health, substance abuse, and prescription drug benefits and overestimate their coverage for long-term care. People who are newly insured in physician networks or health maintenance organizations seem uncertain about what services their plan covers and restrictions on their choice of hospitals.
本数据观察使用了两项调查的数据来探究美国人对其医疗保险的理解。首先，来自一项全国消费者调查的数据用于检验拥有私人医疗保险的人是否正确报告了他们对六项服务的保险范围。其次，来自纽约一项补贴保险试点项目评估的信息用于调查新参保人员对其保险范围的理解程度。基于这些调查，几乎所有拥有私人保险的人都了解其保险计划的基本要素，但低估了他们对心理健康、药物滥用和处方药福利的保险范围，高估了他们对长期护理的保险范围。在医生网络或健康维护组织中新参保的人似乎不确定他们的保险计划涵盖哪些服务以及对他们选择医院的限制。
