Studies examine effects of hospital closures, affordability of coverage

The following studies appear in the July issue of the Journal of Health Economics

• "How Far to the Hospital? The Effect of Hospital Closures on Access to Care": The study -- by Thomas Buchmueller of the University of California-Irvine and National Bureau of Economic Research; Mireille Jacobson, also of the UC Irvine; and Cheryl Wold of the Los Angeles County Department of Health Services -- examines hospital closures occurring in Los Angeles County, Calif., between 1997 and 2003. The study finds that 10% of hospitals in the county closed between 1997 and 2002 and that nine additional acute care hospitals have closed since 2002. According to the study, as patients' distance to the closest hospital increases, more deaths from heart attacks and unintentional injuries occur. The authors recommend that low-cost, nonhospital-based preventive care be promoted to reduce patient deaths after hospital closures (Buchmueller et al., Journal of Health Economics, July 2006).
• "Is Health Insurance Affordable for the Uninsured?": The study -- by M. Kate Bundorf of the Department of Health Research and Policy at the Stanford University School of Medicine and Mark Pauly of the Department of Health Care Systems at the Wharton School at the University of Pennsylvania -- examines the meaning of health care "affordability." The authors examine the relationship between the cost of coverage and the number of uninsured, finding that health insurance was affordable to about one-quarter to three-quarters of uninsured U.S. residents. The authors used the federal poverty guidelines as a basis for whether the uninsured could afford to purchase insurance. The authors conclude that subsidized insurance will not necessarily decrease the number of uninsured if those who can afford to purchase insurance choose not to and that individual mandates to purchase insurance might be the most appropriate way for policymakers to ensure a decrease in uninsured rates (Bundorf/Pauly, Journal of Health Economics, July 2006).

KaiserEDU.org Update
Updated Medicare 101 Tutorial, kaiserEDU.org: The newly expanded tutorial -- narrated by Tricia Neuman, a Kaiser Family Foundation vice president and director of its Medicare Policy Project -- gives an overview of Medicare, describes how it works and explores the program's challenges. The tutorial has been updated to include the latest information on Medicare spending, the prescription drug benefit and future challenges (Kaiser Family Foundation release, 8/23).