The Effects of Managed Competition on the Delivery of Medical Care to Uninsured and Underinsured in Genesee County, Michigan

Abstract

This study explored the financing effects of a national health care reform program of universal coverage for Genesee county. In this study "uninsured" was defined as those persons having no health insurance coverage at all and "underinsured" was defined as the 18 million people in the United States with inadequate coverage. Most of these people are workers, and their dependents, insured by small businesses that can afford only very minimal coverage group employee plans. Data used for this study was from unpublished Blue Cross and Blue Shield of Michigan (BCBSM) data for three major Flint, Michigan hospitals; National Center for Health Statistics - estimates from the National Health Interview Survey -1990; Healthy People -1991; and the Genesee County Census -1990. Total hospitalization costs for just the three disease classifications studied (respiratory, circulatory, and digestive) were estimated. Projected costs were $213,115,270. Sources of revenue to meet these costs were discussed. After calculating possible methods of funding this new health care bill, such as, a federal health care tax and a cigarette tax, a $29 million dollar gap was discovered. It is apparent that along with new taxes a reduction in health care spending will be needed if universal health care coverage is to be implemented. Obvious ways to reduce health costs are to have primary care physicians manage and coordinate care, including some form of rationing of health care. In addition, an increased emphasis on health education and disease prevention will be required.