HEALTH CARE ACCESS: Insurance Coverage Only One Factor

      Declines in health insurance coverage were responsible for only about 20% of the decline in access to health care among Hispanic Americans and young adults between 1977 and 1996, according to a new study from the Agency for Health Care Policy and Research (AHCPR). Other factors "also play an important role" in decreased access, according to authors Samuel Zuvekas, PhD and Robin Weinick, PhD. The authors analyzed data from three household-based medical expenditure surveys -- conducted in 1977, 1987 and 1996 -- that queried respondents about their access to a "usual source of care." The authors found that while whites and African Americans "did not experience significant changes in the probability of having a usual source of care from 1977 to 1996," Hispanic Americans reported a steep decline, from 80.3% in 1977 to 70.4% in 1996. Young adults aged 18-24 experienced a similarly "striking" decline in usual source of care, from 78.6% in 1997 to 66% in 1996. According to the authors, only "20.8% of the large decline in usual sources of health care among Hispanics over this period can be explained solely by the decrease in health insurance coverage; the corresponding figure for young adults is 16.6%" (Health Services Research, April special supplement). The authors conclude that simply increasing health insurance coverage will not eliminate access problems. "[I]nsurance coverage is the first step toward access to high quality services, but not the last step," said John Eisenberg, AHCPR administrator (AHCPR release, 4/6).