Is it really worse to have public health insurance than to have no insurance at all? Health insurance and adult health in the United States

Using prospective cohort data from the 1979 National Longitudinal Survey of Youth, this study examines the extent to which health insurance coverage and the source of that coverage affect adult health. While previous research has shown that privately insured nonelderly individuals enjoy better health outcomes than their uninsured counterparts, the same relationship does not hold for those publicly insured through programs such as Medicaid. Because it is unclear whether this finding reflects a true causal relationship or is in fact due to selection bias on socioeconomic status and health, previous estimates of the contribution of health insurance to inequities in health may have been biased. This study attempts to disentangle these competing hypotheses of causation or selection bias by using fixed effects models with sibling clusters to corroborate--or contradict--the results of a conventional OLS regression. By controlling for unobserved factors shared by siblings, such as parental genetic influences, sibling models estimate health insurance effects that are less affected by selection bias. Findings suggest that, among the US. birth cohorts of 1957 to 1961, the negative relationship between public health insurance and health is not causal, but rather due to prior health and socioeconomic status. Conversely, the lack of health insurance coverage has a strong cumulative negative impact on adult health.     

Inclusion of persons with disabilities in mainstream employment: is it really all about the money? A case study of four large companies in Norway and Sweden

This study investigates how large companies respond to public policy measures to ensure the inclusion of persons with disabilities in mainstream employment based on a case study of four companies in Norway and Sweden. The qualitative interviews, which were conducted with company managers, government representatives in Norway, and non-governmental organisations in Sweden, revealed three overarching themes: (1) ‘legitimacy’, (2) ‘financial interests’ and (3) ‘non-financial support’. The results indicate a more proactive response from the Swedish companies, especially regarding persons with intellectual and learning difficulties. The Norwegian companies reveal a high commitment to their own employees. These findings cannot be explained solely using neo-institutional theory, which holds that organisations demonstrate ‘conformity with powerful institutional myths to strengthen support and secure survival'. The results indicate that inclusive targeted corporate policies and programmes, advisory support, and the agency and value choices of the management might matter more.