Health insurance, treatment and outcomes. Using auto accidents as health shocks

Previous studies find that the uninsured receive less health care than the insured, yet differences in health outcomes have rarely been studied. In addition, selection bias may partly explain the difference in care received. To examine health outcomes and deal with selection problems, this paper focuses on an unexpected health shock—severe automobile accidents where victims have little choice but to receive treatment. Another innovation is the use of a comparison group that is similar to the uninsured: those who have private health insurance but do not have automobile insurance. The medically uninsured are found to receive twenty percent less care and have a higher mortality rate compared to patients with health insurance. It appears that the ability-to-pay of patients has a significant effect on treatment decisions and the additional treatment yields large improvements in health outcomes