Survey Text

1989
1986
1984
1983
1982
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1989

No questionnaire text is available for this sample.


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1986
Survey form view entire document:  text  image

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years old and older. People covered by Medicare have a card that looks like this. Show card.

1a. Is anyone in this family, that is (read names), now covered by Medicare?

[] Yes
[] N(4)
[] DK

b. Is -- now covered?

1 [] Covered
2 [] Not Covered
9 [] DK

Ask only if persons under age 20 in family:
9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

[] Yes
[] No (10)
[] DK

b. Does -- now receive AFDC or ADC?

1 [] Yes
2 [] No
9 [] DK

10a. Does anyone in this family now receive the "Supplemental Security Income" of "SSI" gold-colored check?

[] Yes
[] No (11)
[] DK

b. Does -- now receive this check?

1 [] Yes
2 [] No
9 [] DK

11a. There is a national program called Medicaid which pays for health care for persons in need. (In this State it is also called (name).)
During the past 12 months, has anyone in this family received health care which has been or will be paid for by Medicaid (or (name))?

[] Yes
[] N (12)
[] DK

b. Has -- received this care in the past 12 months?

1 [] Yes
2 [] No
9 [] DK

13a. Is anyone in the family now covered by any other public assistance program that pays for health care?

[] Yes
[] No (14)
[] DK

b. Is -- now covered?

1 [] Yes
2 [] No
9 [] DK

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1984
Survey form view entire document:  text  image

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years old and older. People covered by Medicare have a card that looks like this. Show card.

1a. Is anyone in this family, that is (read names), now covered by Medicare?

[] Yes
[] N(4)
[] DK

b. Is -- now covered?

1 [] Covered
2 [] Not Covered
9 [] DK

Ask for each person "Not covered" in M1. If "Not covered 65 and over," include "or Medicare."
8a. (Many people do not carry health insurance for various reasons.)

Hand Card M.

[Card M not found in flashcards]

Which of these statements describes why -- is not covered by any health insurance (or Medicare)? Any other reason? Circle all responses given.

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8 (Specify) ____

Mark box if only one reason. If "Not covered 65 and over" in M1, include "or Medicare."
b. What is the MAIN reason -- is not covered by any health insurance (or Medicare)?

00 [] Only one reason
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8 (Specify) ____

Ask only if persons under age 20 in family:
9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

[] Yes
[] No (10)
[] DK

b. Does -- now receive AFDC or ADC?

1 [] Yes
2 [] No
9 [] DK

12a. Does anyone in the family now have a Medicaid (or (name)) card which looks like this?
Show Medicaid card(s).

[] Yes
[] No (13)
[] DK

b. Does -- now have this card?

1 [] Yes
2 [] No
9 [] DK

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1983
Survey form view entire document:  text  image

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years old and older. People covered by Medicare have a card that looks like this. Show card.

1a. Is anyone in this family, that is (read names), now covered by Medicare?

[] Yes
[] No (4)
[] DK

b. Is -- now covered? Mark box in person's column.

1[] Cov.
2[] Not Cov.
9[] DK

9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

[] Yes
[] No (10)
[] DK (10)

b. Which (other) family members are included in the AFDC assistance payment?
Mark "AFDC" box in person's column.

1[] AFDC

c. Are any other family members included in this program?

[] Yes (Reask 9b and c)
[] No

10a. Does anyone in this family now receive the "Supplemental Security Income" of "SSI" gold-colored check?

[] Yes
[] No (11)
[] DK (11)

b. Who (else) received this check? Mark "SSI" box in person's column.

1[] SSI

c. Anyone else?

[] Yes (Reask 10b and c)
[] No

11a. There is a national program called Medicaid which pays for health care for persons in need. (In this State it is also called (name)). During the past 12 months, has anyone in this family received health care which has been or will be paid for by Medicaid (or (name))?

[] Yes
[] No (12)
[] DK (12)

b. Who was this? Mark "Medicaid" box in person's column.

1[] Medicaid

c. Anyone else?

[] Yes (Reask 11b and c)
[] No

13a. Is anyone in the family now covered by any other public assistance program that pays for health care?

[] Yes
[] No (Next page)
[] DK (Next page)

b. Who is this? Mark "Other PA" box in person's column.

1[] Other PA

c. Anyone else?

[] Yes (Reask 13b and c)
[] No

top
1982
Survey form view entire document:  text  image

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years
old and older. People covered by Medicare have a card that looks like this. Show card.
1a. Is anyone in this family, that is (read names), now covered by Medicare?

[] Yes
[] N(4)
[] DK

b. Is -- now covered? Mark box in person's column.

1[] Cov
2[] Noc cov
9[] DK

9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

[] Yes
[] No (10)
[] DK (10)

b. Which (other) family members are included in the AFDC assistance payment?
Mark "AFDC" box in person's column.

1[] AFDC

c. Are any other family members included in this program?

[] Yes (Reask 9b and c)
[] No

10a. Does anyone in this family now receive the "Supplemental Security Income" of "SSI" gold-colored check?

[] Yes
[] No (11)
[] DK (11)

b. Who (else) received this check? Mark "SSI" box in person's column.

1[] SSI

c. Anyone else?

[] Yes (Reask 10b and c)
[] No

11a. There is a national program called Medicaid which pays for health care for persons in need. (In this State it is also called (name).) During the past 12 months, has anyone in this family received health care which has been or will be paid for by Medicaid (or (name))?

[] Yes
[] N (12)
[] DK (12)

b. Who was this? Mark "Medicaid" box in person's column.

1[] Medicaid

c. Anyone else?

[] Yes (Reask 11b and c)
[] No

12a. Does anyone in the family now have a Medicaid (or (name)) card which looks like this? Show Medicaid card.

[] Yes
[] No (13)
[] DK (13)

b. Who is this? Mark "Card" box in person's column.

1[] Card

c. Anyone else?

[] Yes (Reask 11b and c)
[] No

Ask for each person with "Card" in 12b:
d. May I please see --'s (and --) card(s)?
Mark appropriate box(es) in person's column.

[] Medicaid card seen
1[] current
2[] expired

3[] No card seen
8[] Other card seen
Specify ____

13a. Is anyone in the family now covered by any other public assistance program that pays for health care?

[] Yes
[] No (Next page)
[] DK (Next page)

b. Who is this? Mark "Other PA" box in person's column.

1[] Other PA

c. Anyone else?

[] Yes (Reask 13b and c)
[] No