Cost-Sharing: A Blunt Instrument

Posted: 8 Aug 2009

See all articles by Dahlia Remler

Dahlia Remler

City University of New York - Baruch College - Marxe School of Public and International Affairs; National Bureau of Economic Research (NBER); CUNY The Graduate Center - Department of Economics

Date Written: August 6, 2009

Abstract

Cost-sharing is a health care cost-containment technique in which health care services are partially paid for by patients out of pocket. Cost-sharing can reduce non-cost-effective care, but it can also undermine the financial protection and access values of health insurance. We review the empirical evidence published since the mid-1980s about cost-sharing's effect on utilization, expenditures, health, and adverse consequences, including how the effects vary by form of care, by health status, and by sociodemographic characteristics. Some cost-sharing, such as emergency department copayments, reduces utilization without any harmful effects, whereas other cost-sharing reduces valuable care such as maintenance drug use among the chronically ill. Cost-sharing should be used judiciously, with attention taken not to reduce highly cost-effective care.

Keywords: cost-containment, health insurance, cost-effective car, access, consumer-driven health plans

Suggested Citation

Remler, Dahlia, Cost-Sharing: A Blunt Instrument (August 6, 2009). Annual Review of Public Health, Vol. 30, April 2009, Available at SSRN: https://ssrn.com/abstract=1445030

Dahlia Remler

City University of New York - Baruch College - Marxe School of Public and International Affairs ( email )

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National Bureau of Economic Research (NBER) ( email )

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CUNY The Graduate Center - Department of Economics ( email )

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