The U.S. health insurance model frequently costs more and provides less care than systems in other Western nations. RAND's health insurance research began in 1971 with the 15-year Health Insurance Experiment, the only community-based experimental study of how cost-sharing arrangements affect people’s use of health services, their quality of care, and their health status. Subsequent research has continued to inform the U.S. policy debate.
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RAND Institute for Civil Justice
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The ACA's goal of expanding access to health coverage has implications for health care costs at many levels: how it will affect individual decisions to obtain insurance, employer decisions about offering coverage, and government spending.
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In this December 2012 Congressional Briefing, Amelia Haviland presents the results of several RAND studies on cost and quality in consumer-directed health plans, including how a switch to such plans may affect the quality of health care for participating families.
“Consumer-directed” health plans (CDHPs), with high deductibles and low monthly premiums, are thought to limit health care spending by tying costs to patients' care. Consumers switching to a CDHP appear to make significant reductions in their spending, but may also be skipping high-value preventive care.
New RAND research finds that eliminating the requirement that all Americans have health insurance would sharply lower the number of people gaining coverage, but would not dramatically increase the cost of buying policies through new insurance exchanges. RAND Economist Christine Eibner discusses the ramifications.
President Obama and several Congressional leaders have recently expressed support for the idea of allowing citizens to buy into a public insurance program as part of any health reform legislation. The intensity of the ensuing debate has been fascinating given the lack of specifics that have been offered by either side.
In a policy forum hosted by the Promising Practices Network and Kansas Action for Children, top experts from around the country shared research and practice knowledge related to federal and state SCHIP policy. Video of the event is available online.
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