Progress 10/01/09 to 09/30/12
Outputs
OUTPUTS: The project resulted in the following outputs: 1. Creation of 3 opinion poll data sets gathering data on New Yorkers' opinion on health reform. Specifically data were gathered in conjunction with the 2008 and 2010 Cornell University Survey Research Institute Empire State Polls (ESP) and through a 2010 re-survey of respondents to the 2008 ESP. 2. Analysis of these data sets and preparation of a working paper entitled "Taxpayer Willingness-to-Pay for Health Insurance Reform: A contingent Valuation Analysis" which has been submitted for consideration for publication at a general economics journal. 3. Development and pilot testing of 3 part curriculum "Understanding Health Insurance." The goals of this curriculum are to give older youth the awareness and knowledge they need to make strategic choices about accessing health care, and to make the most of available health care resources to protect their health and avoid medical debt and the curriculum is designed for use in high schools and other settings which may reach youth 18-25 years in age. Dissemination is planned through project web site and announcements to CCE staff. PARTICIPANTS: Individuals who worked on the project include William White (PI), Kosali Simon (Indiana University), Margaret Johnson (Cornell University), Hannah Weiss and Kurt Latvetti (University of California at Berkeley). Members of the project advisory committee were: Elisabeth R. Benjamin, MSPH, JD, Director, Health Care Restructuring Initiatives, Community Service Society of New York; Benita L. Law-Diao, Program Research Specialist III, Bureau of Child Health Plus Enrollment, Division of Coverage and Enrollment, Office of Health Insurance Programs, NYS Department of Health; Betty Falcao, Tompkins County Health Planning Council; Ann Gifford, Tompkins CCE; Stefanie Hubert, Orange CCE; John Krout, Director, Ithaca College Gerontology Institute; Nancy Marie Riegelsperger, Steuben CCE; Melissa Seeley, New York State Health Foundation; John W. Turner, Vice President of Public Relations, Cayuga Medical Center. Pilot sites for project curriculum were the Lehman Alternative Community School in Ithaca, NY, and the Tompkins County Learning Web Housing Scholarship program. TARGET AUDIENCES: Target audiences for project opinion survey research are health policy researchers and health policy makers. Target audiences for educational programming being developed as part of the project include CCE staff, secondary school educators and other parties interested in youth education PROJECT MODIFICATIONS: Project plans originally included participation in the 2008 ESP poll. During the course of the project, opinion survey research was augmented to also include participation in the 2010 ESP poll and a re-survey in 2010 of respondents to the 2008 ESP. This allowed us not only to compare cross section data on opinions about health reform before and following the onset of the 2008 economic recession, but also to examine how individual opinions changed over time using re-survey data.
Impacts
The project lead to the following outcomes: A)Collection and analysis of data on New Yorkers' opinions about Health Insurance Reform: Analyzing opinion survey data collected for the project, the project has resulted in the preparation of a working paper "Taxpayer Willingness-to-Pay for Health Insurance Reform: A contingent Valuation Analysis" which has been submitted for publication to a general economics journal. Key findings reported in this paper are as follows: i. Analysis of cross section data from the 2008 and 2010 EPS surveys indicates that there is broad-based and deep support for reducing the number of the uninsured in New York. Further, despite a major economic downturn and passage of national reforms which plausibly could have diluted support for state specific reforms, the average willingness-to-pay of respondents remained remarkably stable between 2008 and 2010. ii. In both 2008 and 2010 more than 80% of respondents were prepared to pay additional taxes of $5 or more per year to reduce the overall number of New York uninsured by a quarter and lower-bound estimates of willingness-to-pay by New York residents exceeded $90 per respondent in both years. This translates into a willingness-to-pay of over $2,800 per uninsured covered per year and approaches the average per year cost of covering an individual under Medicaid nationally. iii. While average willingness-to-pay remained stable, longitudinal analysis of study panel data between 2008 and 2010 reveals that there was substantial variation in willingness-to-pay by individual survey respondents over time. Average willingness-to-pay remained stable in the aggregate primarily because changes in individual willingness-to-pay netted out. iv. Examining sources of individual variation in willingness-to-pay, the explanatory power of economic variables such as employment status or health insurance coverage is quite low. Willingness-to-pay is, however, strongly associated with in opinions about health reform in cross sectional analysis and in longitudinal analysis, with changes in these opinions over time. In addition to contributing to the state of knowledge about public support for health insurance reform, this paper is the first to our knowledge to: a) use double bound contingent valuation techniques to assess willingness-to-pay for health insurance reform; and b) to collect and analyze data on individual willingness-to-pay for health insurance reform over time. B) "Understanding Health Insurance" Curriculum: The project has led to the creation of a three lesson educational curriculum "Understanding Health Insurance" targeted for youth 17 to 18 years old. This curriculum will be posted on the project web site and made generally available to CCE staff and other educators for use in New York State and elsewhere. In the long run, it is hoped that these materials may not only be used to directly impact on youth in New York State and elsewhere, but they will provide the basis for future additional curriculum development to facilitate youth understanding of health insurance and access to coverage.
Publications
- Project web site: www.uhi.human.cornell.edu (2012)
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Progress 10/01/10 to 09/30/11
Outputs
OUTPUTS: The goal of this project is to integrate research and extension activities in the area of health insurance and reform. Key project objectives are: 1) to use survey research methods and the Cornell Empire State Poll (ESP) to examine New Yorker's opinions about health reform, how their opinions have changed over time, including their willingness to pay for reform, and their perceptions about gaps in their knowledge about health insurance and reform options and unmet needs for information; 2) to draw on this research and the general literature to inform the development of educational programming for use by CCE, secondary school educators and other interested parties which will assist New York families, including those in rural areas, in making better decisions about their health insurance and better participating in public policy debates about health reform. Based on findings from our survey research, the specific focus selected for this component of our research has been the development of curriculum materials to assist older New York youth in obtaining the knowledge they need to make strategic choices about accessing health insurance, and to make the most of available health care resources to protect their health and avoid medical debt. During the past year, the following activities were carried out: a) Analysis of survey data collected from 2008 ESP and the 2010 ESP on New Yorkers' views on health reform and their willingness-to-pay for health reform: and b) Preparation of a draft of a four-lesson "Understanding Health Insurance" curriculum for use with older youth. PARTICIPANTS: After being on leave from Cornell last year, co-investigator Professor Kosali Simon has joined the faculty of the University of Indiana in Bloomington IN. This is not expected to have any impact on the ability to complete the project. TARGET AUDIENCES: Target audiences for project survey research are health policy researchers and health policy makers. Target audiences for educational programming being developed as part of the project include CCE staff, secondary school educators and other parties interested in youth education. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
1. Findings from analysis of survey data collected from 2008 ESP and the 2010 ESP on New Yorkers' views on health reform and their willingness-to-pay for health reform indicate that despite the economic downturn starting in 2008, overall willingness-to-pay for health reform among New Yorkers remained relatively stable between 2008 and 2010. A paper co-authored with Kosali Simon and William White reporting these findings was presented by former project research assistant Kurt Latvetti at the 2011 Annual Research Conference of the Association for Public Policy and Management Nov. 3 -5, 2011, Washington, DC, to an audience that included scholars and decision makers. 2. A draft was completed of a four-lesson "Understanding Health Insurance" curriculum targeted at older youth. This draft curriculum will be used for pilot testing and development of a final product during spring and summer of 2012.
Publications
- No publications reported this period
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Progress 10/01/09 to 09/30/10
Outputs
OUTPUTS: A talk was presented by me "Willingness-to Pay for Health Reform: A Longitudinal Analysis" 3rd Biennial Conference, American Society of Health Economists (ASHE), Ithaca NY, June 20-23, 2010, to a national audience of scholars and policy makers. PARTICIPANTS: Cornell Faculty: William D. White Kosali Simon (on Leave Indiana University 2010-2011) Research Assistants: Anna Hill Kurt Lavetti Margaret Alice Johnson Thunyapor Sindhuseka Hanna M Weiss. Advisory Board Members:Aloja Aierwele, Office of Assemblywoman Lifton, D-125th A.D., Elisabeth R. Benjamin, MSPH, JD, Director, Health Care Restructuring Initiative, Matt Bishop, Young Invincibles, Travis Brooks, Program Administrator, Greater Ithaca Activities Center, Betty Falcao, Executive Director, Tompkins County Health Planning Council, Beverly Chin, Health Access Coordinator, Tompkins County Health Planning Council, Barbara Henza, Cortland County Cooperative Extension and Statewide Liaison to the National Endowment for Financial Education's High School Financial Planning Program, Helen Ranck, Financial Management Educator, Tompkins County Cooperative Extension, Nancy Marie Reigelsperger, Financial Educator, Steuben County Cooperative Extension, Melissa Seeley MPH, Program Officer, New York State Health Foundation, Megan Tifft, 4-H Leader, Cornell Cooperative Extension, Tompkins County TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Study design was modified to include fall 2010 resurvey of participants in 2008 Empire State Poll following the passage of national health reform. Data from this resurvey will supplement an initial re-survey of of these participants done in spring 2010.
Impacts
The goal of this project is to integrate research and extension activities in the area of health insurance and reform. Key project objectives are: 1) to use survey research methods to examine New Yorker's opinions about health reform, how their opinions have changed over time and their perceptions about gaps in their knowledge about health insurance and reform options and unmet needs for information; 2) to draw on this research to inform the development of educational programming for use by CCE, secondary school educators and other interested parties which will assist New York families, including those in rural areas, in making better decisions about their health insurance and better participating in public policy debates about health reform. Research is utilizing the 2010 Cornell Survey Research Institute (SRI) Empire State Poll (ESP) and re-surveys of individuals previously surveyed on health reform issues in the 2008 ESP to examine New Yorkers' opinions about health reform, how their opinions have changed over time, and their perceptions about gaps in their knowledge about health insurance and reform options and unmet needs for information. New survey research conducted in 2010 has two goals. The first is to examine how attitudes may have changed since 2008. The second is to examine the extent to which New York residents would like additional information about health reform and if so, in what areas in order to provide a basis for developing educational tools. Analysis of data is in progress. Findings indicate that the vast majority of New Yorkers view health reform as an important issue and there is support for a range of reform options, although the level of support varies between specific options. Findings also suggest not only that there was a substantial willingness to pay for reform increasing coverage in 2008, but that willingness-to-pay has remained similar in 2010 despite adverse economic conditions. In addition, findings suggest that a substantial number of New Yorkers are interested in additional information about health insurance and reform. A second additional re-survey is in progress to evaluate the impact of the passage of federal health reform on New Yorkers' views. Preliminary drafts of educational materials for New York youth have been developed and presented to an advisory board with expertise in education and outreach and health insurance. Revisions of these materials are now underway and a pilot study is planned for spring, 2011.
Publications
- No publications reported this period
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