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Health Expenditure: Private health insurance: who has it?
Health status3 The 1989-90 National Health Survey found that about one-third of people who considered their health to be poor were covered by private health insurance. The highest levels of private health insurance coverage were found among people who considered they were in excellent health, regardless of age. However, this finding is confounded by income which is positively correlated with both age and health status. PROPORTION OF PEOPLE WITH PRIVATE HEALTH INSURANCE, 1989-90
Source: National Health Survey Income The level of private health insurance coverage increases with increasing income, and a greater variation in coverage occurs across income groups than across age, family status or health status groups. Of people in contributor units with low incomes (less than $240 gross a week) in 1992, 24% (637,000 persons) were covered by private health insurance compared to 68% (4.6 million persons) of those in contributor units with high incomes ($600 or more gross a week). Of all persons in contributor units with private health insurance 8% were in low income units, 33% in middle income units and 59% in high income units. Two-thirds of contributor units who ceased private health insurance in the two years prior to 1992 gave their reason as no longer being able to afford it. PERSONS IN CONTRIBUTOR UNITS WITH PRIVATE HEALTH INSURANCE, 1992 Source: Health Insurance Survey
Age Private health insurance coverage generally increases with age. However, of those contributor units where the contributor was aged 65 years or more in 1992, 61% had no private health insurance. While this is in part due to the generally lower incomes of people in this contributor age group, many also had access to government health concession cards. Of contributor units where the contributor was aged 65 years or more, 79% were covered by government health concession cards. However, 74% of those not covered by government health concession cards had private health insurance. This left about 80,000 contributor units where the contributor was aged 65 years or more with neither private health insurance nor government health concession cards. Type of private health insurance coverage also varies with age. Persons in contributor units where the contributor was aged 35-64 years were four times more likely to have ancillary only insurance than those contributor units where the contributor was aged 65 years or more. Part of the reason for this may be that for the aged some ancillary services are available at no, or low, cost through public hospitals and community health centres. Some States also have low cost dental and eye care schemes for the aged. Age and income When age and income are combined as factors involved in private health insurance cover, a more complicated pattern is revealed, although, in general terms, private health insurance coverage increases with age and income. In 1992, the youngest, low income contributor units had the lowest level of private health insurance coverage at 21% and the oldest, high income units had the highest at 84%. Private health insurance coverage increased for each age and income group except the oldest, middle income contributor units whose level of coverage was lower than that of middle aged, middle income units. Contributor units with high incomes were more likely than other groups to have combined hospital and ancillary insurance, 77% compared to 59% of contributor units with low incomes. CONTRIBUTOR UNIT INCOME BY AGE OF CONTRIBUTOR, 1992
(b) $240-$599 gross per week. (c) $600 or more gross per week. (d) Includes income not known. Source: Health Insurance Survey Family composition Contributor units consisting of couples (with or without dependent children) had the highest levels of private health insurance coverage (over 50%), while those consisting of one contributor and dependent children had the lowest (23%). For all contributor unit types level of insurance coverage increases with income. The higher level of private health insurance coverage for contributor units containing couples reflects their generally higher incomes. Of such contributor units, 48% received high incomes, 42% received middle incomes and 4% received low incomes. Of contributor units consisting of a contributor (with or without dependent children), 15% received high incomes, 40% received middle incomes and 42% received low incomes. Couples with dependent children were more likely than other types of contributor units to have hospital and ancillary cover while couples without dependent children had the highest rate of hospital only cover. Ancillary only cover was more prevalent in contributor units with dependent children than in those without. PROPORTION OF CONTRIBUTOR UNITS WITH PRIVATE HEALTH INSURANCE, 1992
(b) $240-$599 gross per week. (c) $600 or more gross per week. (d) Includes income not known. Source: Health Insurance Survey CONTRIBUTOR UNITS WITH PRIVATE HEALTH INSURANCE, 1992 Source: Health Insurance Survey Endnotes 1 Unless otherwise stated statistics presented in this review are drawn from the Health Insurance Survey. 2 Willcox S. (1991) A Healthy Risk? Use of Private Health Insurance National Health Strategy Issues Paper No. 4.
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