Codes and Frequencies
Description
SINGLE is a recoded variable created by the IPUMS NHIS staff, which indicates whether the person was covered by an insurance plan that only paid expenses for one type of health care service. In 1989 and for 1999 forward, having such a single service plan did not count as having health insurance. For 1993 to 1996, by contrast, the NHIS recognized single service plans as a form of insurance coverage. In 1993-1996, persons who reported having any form of private insurance were asked for clarification of whether their plan paid for "a variety of health care services" (i.e., was comprehensive coverage) or "for only one type of service or care" (i.e., was a single service plan).
Users are strongly encouraged to review the user notes Insurance Data Collection and Private Insurance Definitions.
Related variables
For 1999 forward, the following variables reflect the type of single service plans available:
- SSAIDS: Single service plan for AIDS care
- SSCANCER: Single service plan for cancer treatment
- SSCATAST: Single service plan for catastrophic care
- SDENTALE: Single service plan for dental care
- SSDISABL: Single service plan for disability insurance
- SSDRUGS: Single service plan for prescriptions
- SSHOSPIC: Single service plan for hospice care
- SSHOSPIT: Single service plan for hospital care
- SSLONGT: Single service plan for long-term care
- SSVISION: Single service plan for vision care
- SSOTHER: Single service plan for some other type of care
The Field Representative's Manuals for 1989 and 1999 forward stated that single service plans were not a form of private comprehensive insurance.
The 1989 Manual defined single service plans ("specialty health care" plans) as "usually limited to one type of service and frequently obtained to supplement a comprehensive plan that may not provide that type of coverage." 1989 was the first year in which information on single service plans was collected, for the Manual noted they were a "relatively new concept." The 1989 Manual instructed interviewers not to include, among single service plans, those comprehensive plans that had additional benefits paid for in the premium payment. For example, "some comprehensive plans pay for prescriptions and this coverage is included in the premium payment. This service would be considered part of their comprehensive plan and not a single service." Interviewers could probe to determine whether a particular service was included in the respondent's comprehensive coverage.
For 1993 to 1996, respondents were asked whether they had any private insurance, including single service plans. If the answer was affirmative, they were then asked whether the plan paid for a variety of services (a comprehensive plan) or one type of service.
The wording of questions about single service coverage changed over time.
1989
- (In addition to the plan(s) you just mentioned) Is anyone in the family now covered by an insurance plan that pays for only one type of health care service, such as nursing home care, eye care, or prescriptions?
- Does this plan pay for a variety of health care services or does it pay for ONLY ONE type of services or care?
- What kind of health insurance or health care coverage {do/does} {you/subject's name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized. Response categorySingle service plan (e.g., dental, vision, prescriptions)
Comparability
Apart from universe changes and the shifts in question wording noted in the variable description, SINGLE is comparable over time.
SINGLE is not comparable to the variable SINGLEE, which is included in the NHIS public use files for 1997 forward. Beginning in 1997, the NCHS staff created insurance coverage variables (including SINGLEE) that were back-edited to be consistent with the plan names respondents provided. In cases of mismatch between the plan name and the actual type of plan, back-editing reassigned individuals to the correct response categories. The NCHS describes the back-edited variables as more accurate, and most researchers focusing on the period for 1997 forward should use SINGLEE to study single service coverage.
The responses for SINGLE did not undergo back-editing to insure accuracy of about the type of insurance coverage. Because back-editing was only introduced in 1997, the data from respondents' original answers is more consistent over a long time span. Researchers studying the period before and after 1997 should thus employ SINGLE.
Universe
- 1989: All persons
- 1993: Persons in quarters 3 or 4 who have a private health insurance plan.
- 1994-1996: Persons who have a private health insurance plan.
- 1999-2018: All persons with health insurance coverage
Availability
- 1989, 1993-1996, 1999-2018
Weights
- 1989, 1994-1996, 1999-2018 : PERWEIGHT
- 1993 : SAMPWEIGHT
