Patient Cost Sharing in Low Income Populations
Name
Gruber_Patient Cost-Sharing in.pdf
Size
154.25 KB
Format
Adobe PDF
Checksum (MD5)
4ff74c8c7d0ed4c439a71c0c693704d7
Author(s)
Chandra, Amitabh
Gruber, Jonathan
McKnight, Robin
Date Issued
May 2010
Journal
American Economic Review
Publisher
American Economic Association
Citation
Chandra, Amitabh, Jonathan Gruber, and Robin McKnight. “Patient Cost Sharing in Low Income Populations.” American Economic Review 100.2 (2010): 303-308. © 2011 AEA. The American Economic Association
Version
Final published version
Abstract
Economic theory suggests that a natural tool to control medical costs is increased consumer
cost sharing for medical care. While such cost
sharing reduces “full insurance” (wherein
patients are indifferent between falling sick
or remaining healthy), a greater reliance on
coinsurance and copayments can, in theory,
stem patient and provider incentives to engage
in moral hazard. These issues are particularly
salient for low income populations who are at
the center of current efforts to expand coverage
(among the uninsured in 2008, 38 percent had
incomes below the federal poverty line (FPL),
and 52 percent had incomes between 100 and
299 percent of the FPL (Kaiser Commission on
Medicaid and the Uninsured 2009)). As insurance
is expanded to these groups, it is important
to understand how they respond to greater levels
of patient cost sharing. On the one hand, smarter
plan design could help reduce the fiscal pressures
associated with insurance expansion. But
on the other, it is also possible that low income
recipients are unable to cut back on utilization
wisely and, consequently, experience hospitalization
“offsets” as a result of greater levels of
patient cost sharing. In particular, there remains
a concern among many that higher cost sharing
on primary care will lead to less effective use of
primary care, worse health, and, consequently,
higher downstream costs at hospitals (the so-called
“offset effects”).
MIT Department
Massachusetts Institute of Technology. Department of Economics
Terms of Use
Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1257/aer.100.2.303
