The Effect of Health Insurance on Patient Demand for Appropriate Levels of Medical Care

This study investigates the impact of health insurance coverage status on patient demand for appropriate levels of medical care. A discrete choice framework and multinomial logistic regression are used to estimate the effect of different types of health insurance coverage on the probability of a patient scheduling different combinations of medical care following an acute diagnosis/acute event. The study sample consists of 2008-2012 MEPS respondents ages 19 to 64 who have been diagnosed with coronary heart disease and stroke (CHDS), cancer, or diabetes, which are patient groups whose diagnoses have a sudden and "rapid onset" and whose diagnoses require them to utilize medical care at a particular threshold to ensure that the risk of future acute events is minimized. The results show that health insurance coverage is associated with increased use of appropriate levels of physician care, but does not promote increased use of cost-effective care among the publically insured. These results have important policy implications for understanding the wider impacts of ACA related public insurance expansions to health outcomes.