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  • Snapshots: Insurance Premium Cost-Sharing and Coverage Take-up

    Issue Brief

    One of the many reasons an individual may be uninsured is that she or he decides an employer’s offer of health insurance is too expensive. Several studies have noted the likelihood that a worker will decline an employer’s offer of health insurance increases with the amount he or she is required to contribute. Alternatively, employees may obtain coverage through a spouse, opt for publicly provided coverage if eligible, or decide to do without coverage entirely.…

  • Snapshots: Illustrating the Potential Impacts of Adverse Selection on Health Insurance Costs in Consumer Choice Models

    Issue Brief

    A current strategy for addressing the cost of health insurance involves consumer-directed health plans (CDHPs). These plans generally are less expensive than more traditional health plan designs, but it is not clear whether the lower costs derive entirely from the new benefit structure or whether some of the savings result because these new arrangements attract a disproportionate share of enrollees in good health who have relatively low health spending. Public discussions of enrollment bias tend…

  • The Role of Consumer Copayments for Health Care: Lessons From the RAND Health Insurance Experiment and Beyond

    Report

    The appropriate level of cost-sharing for patients remains a key issue in designing both private and public health insurance. This report reviews the groundbreaking RAND Health Insurance Experiment from the 1970s to offer insights into current policy debates about appropriate cost-sharing levels. One of the most ambitious health policy studies in U.S. history, the RAND experiment randomly assigned thousands of families to insurance with varying levels of patient co-insurance. The researchers followed the participants for…

  • Illustrating the Potential Impacts of Adverse Selection on Health Insurance Costs in Consumer Choice Models

    Other Post

    Health Care Spending in the United States and OECD Countries  Health spending is rising faster than incomes in most developed countries, which raises questions about how these countries will pay for future health care needs.  The issue may be particularly acute in the United States, which not only spends much more per capita on health care than any other country, but which also has had one of the fastest growth rates in health spending among…

  • Snapshots: Distribution of Out-of-Pocket Spending for Health Care Services

    Issue Brief

    How much people should pay out-of-pocket for health care is a much-debated issue in health policy. New health insurance products with higher out-of-pocket shares are becoming more evident in the private market, and some states are considering ways to increase enrollee financial responsibility in state Medicaid programs.  This paper presents information about current out-of-pocket spending by individuals with the purpose of providing context for future health policy discussions. Current proposals suggest that increasing the amount that…

  • Retired Steelworkers and Their Health Benefits: Results from a 2004 Survey

    Report

    This Kaiser survey report looks at how the bankruptcies of two steel companies, the LTV Corporation and Bethlehem Steel, affected health coverage for the companies' retirees and dependents. The bankruptcies left about 200,000 retirees and spouses without retiree health coverage in 2002 and 2003. The report provides insight into the impact of a tax credit enacted by Congress in 2002 to provide temporary assistance to workers and retirees in "distressed" industries, including the steel industry.…

  • Snapshots: Comparing Projected Growth in Health Care Expenditures and the Economy

    Issue Brief

    The rising cost of health care is much in the news. Health costs continue to grow faster than national income and, despite research indicating that we the get good value for the increased spending, some policy makers and health analysts question whether governments and private employers can continue to finance the level of care that they do today. This paper illustrates the magnitude of savings that would be needed in order to bring health care…

  • A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan

    Report

    Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for by health plans. Health plans are required to follow state and federal rules for handling their enrollee’s complaints and appeals inside the health plan, known…

  • Medical Malpractice Law in the United States

    Report

    In recent years, medical malpractice law and insurance have become popular topics for debate in Washington, DC and around the country. This report provides an overview of the issues surrounding medical malpractice law, including the legal changes that states have made over the past thirty years in response to periodic concerns about rising medical malpractice costs; some newer proposals for changing medical malpractice law; and trend data for malpractice claims. This report was prepared for…

  • Follow The Pill: Understanding the U.S. Commercial Pharmaceutical Supply Chain

    Report

    The report describes the U.S. pharmaceutical supply chain, following prescription drugs as they move from manufacturers, to wholesale distributors, to pharmacies, and ultimately to patients. The report describes both the physical distribution of drugs through the chain, as well as the flow of money and the financial relationships among the key players. It was prepared for the Foundation by Dan Mendelson and The Health Strategies Consultancy. Report (.pdf)