health care spending and the dynamics of cross-subsidies of medical care costs in a nontraditional family have not been fully specified in our recommended approach. Much more research is necessary to inform the complete specification of the measure.

Future improvements in the data available will also require reexamination of the MCER methodology. We think that both HHS and the Census Bureau, under the guidance of the interagency coordinating group, should make the appropriate investments to ensure that this research be done to improve the measurement of medical care economic risk and burden in the future.


The introduction of a new measure of medical care economic risk will require thoughtful exposition and communication if the estimates are to be generally understood and accepted by policy makers, the media, and the public. It would be a disservice to simply release a new measure without a well-constructed explanation of what the measure does and does not represent. The panel envisions an analytic report produced by HHS and Commerce, which, following external review, would accompany the annual release of the MCER. This analytic report should provide policy makers, the media, and the public with an explanation of the measure and what it shows in a rigorous but nontechnical manner.

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