Lower-Income Families Pay A Higher Share Of Income Toward National Health Care Spending Than Higher-Income Families Do

Institute of Health Administration at Georgia State University, Atlanta, Georgia, USA.
Health Affairs (Impact Factor: 4.97). 09/2011; 30(9):1637-46. DOI: 10.1377/hlthaff.2010.0712
Source: PubMed


All health care spending from public and private sources, such as governments and businesses, is ultimately paid by individuals and families. We calculated the burden of US health care spending on families as a percentage of income and found that at the national level, lower-income families pay a larger share of their incomes toward health care than do higher-income families. Specifically, we found that payments made privately, such as those for health insurance or out-of-pocket spending for care, and publicly, through taxes and tax expenditures, consumed more than 20 percent of family income for families in the lowest-income quintile but no more than 16 percent for families in any other income quintile. Our analysis provides a framework for considering the equity of various initiatives under health reform. Although many effects remain to be seen, we find that, overall, the Affordable Care Act should reduce inequities in the burden of paying for national health care spending.

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    • "Among people with private insurance, only 4% of adults had family incomes below the poverty threshold, whereas the majority (68% with diabetes and 71% without diabetes) had incomes well above the poverty threshold (poverty income ratio ≥3.0, a yearly income of ≥$66,000 for a family of four). Furthermore, the proportion of income spent on private insurance premiums and family medical care was higher for low-income people, a result supported in previous work (12). Second, unemployment has significantly increased over the past decade, leaving many without the means to pay for insurance (13). "
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