Expanding the focus of health insurance education for Medicare beneficiaries

Health insurance education plays an important role in helping consumers make informed decisions about their need for supplemental coverage. This article reviews findings on the knowledge of Medicare beneficiaries about their health insurance coverage. Then, current health insurance education programs are examined with regard to their ability to meet the needs of a competition-based public policy. Barriers outside the control of individuals that impede the growth of the long-term care insurance market are identified and the need for an alternative, broader form of health insurance education is suggested. Changes in the scope and content of health insurance education are proposed that would educate the elderly to their own needs as well as the larger policy issues. An expanded model of education based on the concept of the Swedish study circle is discussed to illustrate the possibility of combining individual knowledge and public debate about complex social issues.     

Toward the Tailoring of Sexual Health Education Messages for Young Women: A Focus on Tourist Experiences

Perceived anonymity and decreased influence of sexual double standards in tourism provide female travelers with opportunities for sexual experimentation and risk taking. The purpose of this study was (a) to identify the clusters of risk takers among young women based on their perceptions of and motivations for sexual risk taking in tourism and (b) to profile the clusters with respect to the psychological, sexual, demographic, and tourist characteristics. The data were collected through an online survey of 853 women (age in years: M = 23.5, SD = 6.67). Five clusters of sexual risk takers emerged based on their factor-analyzed risk perceptions and motivations. These clusters were interpreted as (a) diversely motivated broad risk perceivers; (b) fun-seeking broad risk perceivers; (c) diversely motivated physical risk perceivers; (d) anonymity- and empowerment-seeking risk disregarders; and (e) unmotivated broad risk perceivers. Women in these clusters differed in their intentions to engage in sexual risk taking in tourism, sensation-seeking propensities, perceptions of tourist characteristics, levels of sexual experience, and demographic backgrounds. Results suggest tailoring sexual health promotion messages based on cluster affiliation, leveraging cluster-specific risk perceptions, motivations, and personal characteristics. This study provides recommendations for individually tailored, context-specific, age-appropriate, and gender-sensitive sexual health education programs.     

Expanding Educational Assumptions for Social Work Education

Rapid expansion of educational research and conceptualization combined with increased emphasis on relevance and effectiveness as values within the educational institution encourage expansion of the assumptions made by social work educators. Such expansion forces recognition of the complexity of the educational transaction and of the importance of flexibility as a teacher characteristic. But certain new assumptions suggest undeveloped opportunities for facilitating significant student learning. This article identifies four such opportunities based on assumptions about individual differences, cognitive functioning, and affective learning. A complex, growth-oriented view of social work education is emphasized.     

Trends in Employee Wage and Health Insurance Compensation for Employer-Sponsored Health Insurance (ESI) Coverage

Health insurance coverage continues to be an important benefit of employment and employer-sponsored insurance is the most prominent form of health coverage in the US. We examine trends in both employer and employee contributions to the costs of health insurance premium between 2002 and 2005 and assess these contributions relative to changes in worker wages. We do this for the US overall and for the 50 states plus the District of Columbia. We found a significant increase of 15.5% in the share of total compensation going toward health benefits (from 12.3–14.2%) for workers with individual coverage and an increase of 13.5% (from 20.6–23.4%) for workers with family coverage. Wages over this time period decreased 3.0% for workers with individual coverage and increased 0.8% for workers with family coverage.     

Support for National Health Insurance: Intercohort Differentials

Past research has demonstrated that the majority of the Americanpublic favor some form of national health insurance (NHI), butthe sources of this support have not been clearly identified.This paper shows that support for NHI follows party lines, withDemocrats most favoring it, followed by Independents and Republicans.The young, women, blacks, the less educated (among others) alsofavor NHI more than others, but it is apparently not a "personalneed" for the insurance that prompts this support. Lack of adequateinsurance coverage, dissatisfaction with current care, or pooraccess to health care are not associated with support for NHI.Instead, cognizance of the larger socioeconomic issues (particularlyrising society-wide health care costs), in addition to politicalidentification, generates support for NHI.     

Health insurance coverage as people approach and pass age-eligibility for Medicare

This study uses six waves of the Health and Retirement Study (HRS) to measure dynamics of health insurance coverage as people approach and pass age-eligibility for Medicare. Thirteen percent of 59- to 64-year-olds were uninsured and 13% of 65- to 70-year-olds relied solely on Medicare. Those unmarried, in good health, and in poor health had an increased likelihood of being uninsured before age-eligibility for Medicare, while non-whites and those in good health had an increased likelihood of having Medicare-only coverage after age-eligibility for Medicare. Although only a small percentage was continually without coverage or with Medicare-only coverage, a substantial percentage had these coverage types at some point. Limitations and policy implications are included.     

The Impact of the Labor Market on Health Insurance

This paper examines the impact of labor market conditions on employer-sponsored health insurance (ESHI). Unique data from the Louisiana Health Insurance Surveys linked to unemployment data and the Louisiana Job Vacancy Surveys prior to and after Hurricane Katrina provide very large variation in the job vacancy and unemployment rates, our measures of labor market conditions. Results suggest a significant relationship between both unemployment and industry specific job vacancy rates and ESHI.     

法律素质教育：拓展高校德育的有效途径

努力拓展新形势下大学生思想政治教育的有效途径,是摆在德育工作者面前的重要课题.我国正处于经济和社会体制的转型时期,时代特征使道德主体面临困惑和迷惘,德育实效性受到挑战.由于法律与道德的辩证关系,加强大学生法律素质教育无疑可增强德育实效性.要明确法律素质教育内容,改革教育方法,培育良好教育大环境.     

素质拓展体验式教育实证研究

在经济高速发展、社会快速变革的背景下,高等学校传统的思想政治教育模式和手段已难以满足当代大学生思想政治教育工作的内在要求,创新教育模式,提高教育效果已是迫在眉睫。本文以南京工程学院开展素质拓展体验式教育,创新高校思想政治教育模式为案例,分析研究素质拓展体验式教育在大学生思想政治教育工作中的重要作用,探讨建立素质拓展体验式教育模式。     

Health Insurance and Worker Retention in the Construction Industry

Using samples of blue collar construction workers from the 1996 and 2001 SIPP, a shared frailty survival model shows that controlling for wages, occupational and demographic factors, both portable union and nonportable nonunion employer-provided health insurance increase the probability of worker retention within the construction industry. Portable union health insurance increases the probability of worker-industry retention by 30 to 41% compared to 13 to 18% for nonunion employer-provided insurance. Our research suggests that by encouraging industry retention, health insurance preserves and encourages the accumulation of human capital in a turbulent industry with high firm-and-industry-labor turnover and also may reduce worker disabilities by immediately treating medical problems. Furthermore, in the union sector of construction where health insurance is portable across signatory contractors, the problem of job-lock inefficiencies is reduced.     

Understanding the diverse needs of the Medicare population: implications for Medicare reform

Meeting the health care needs of millions of elderly and disabled Americans is central to the debate over Medicare's future. Using data from a nationally representative survey of 3,309 beneficiaries, Medicare's most vulnerable beneficiaries were profiled, examining variations in coverage, satisfaction, access, and financial difficulties. A substantial portion of the Medicare population--two thirds--were found to have health problems or low incomes. The analysis found that about 40% of beneficiaries with incomes below the poverty level, in fair or poor health, or with ADL limitations, have difficulties paying their medical bills or getting needed health care. Medicare's disabled, under-65 beneficiaries are at even higher risk: nearly half (47%) have health care access problems or deal with financial hardship due to medical bills. The diverse needs and experiences of the Medicare population are underscored, providing new insights into the challenge of maintaining or improving protection for those with greatest need while assuring the long-term fiscal viability of the program.     

Urban and Rural Differences in the Provision of Health Insurance Coverage for Children of Divorce

Abstract

Using data from divorce case records in New Hampshire this study examined urban and rural differences in the provision of health insurance coverage for children of divorce. In the overall sample of cases (N= 474) results from a chi-square test found rural children (N= 123) to be nearly twice as likely to be uninsured than urban children (N= 351). Results from the logistic regression in the urban county found fathers' and mothers' incomes to increase the log odds of children having access to health insurance. Mothers' employment also increased the log odds of children being insured. In the rural county fathers' earnings and mothers' employment increased the log odds of children having access to health insurance. Pre-school age (0-5) decreased the log odds of children being insured. Implications for family practitioners in rural areas are discussed.     

Administrative Responsiveness to the Disadvantaged: The Case of Children's Health Insurance

Issues of administrative responsiveness to the disadvantaged(as distinct from formal policy responsiveness) possess importantimplications for American democracy. In this regard, the administrativepractices that facilitate or impede enrollment, or take-up,in social programs deserve attention. This study focuses ontwo means-tested programs in the context of American federalism,Medicaid and the State Children's Health Insurance Program.Based on an in-depth analysis of seventeen states, we developan index of administrative responsiveness to the disadvantagedrelated to take-up. We then explore some possible sources ofvariation in responsiveness rooted in the task environment,political ideology, good government culture and practice, andsignals from political principals. Our findings point to theneed to refine and expand upon existing explanations of statevariation in social programs. Among other things, this studysuggests the political importance of international (not interstate)population mobility and gubernatorial leadership (rather thanbureaucratic autonomy) in shaping administrative responsivenessto the disadvantaged. It also points to the need for a contingentapproach in examining whether the greater presence of racialminorities tends to depress such responsiveness.