Use of health insurance in county-funded clinics: issues for health care reform.

This article determines to what extent people with and without health care insurance use public health care facilities and various health care services. A descriptive study analyzed the characteristics of 6,298 patients from four county-funded primary health care clinics. The patients were overwhelmingly poor regardless of insurance status. High cost-sharing requirements, coupled with larger families and low wages, may be causing some people with insurance to use public clinics. Implications for social work policy and practice are discussed.