Cost Sharing for Medical Care Services

This paper was originally presented as testimony before the Subcommittee on Defense of the United States Senate Appropriations Committee on June 12, 1984. It reviews preliminary findings of the RAND Health Insurance Study, an experiment to learn the effects, both on families' use of medical service and on their health status, of requiring families to pay for a portion of their medical care services. The most important result concerning use was that families for whom all medical services were free spent about 50 percent more than families on the least generous plan (which required payment of 95 percent of bills up to a $1000 maximum). Results with respect to health status indicate that the average person's health changed very little, despite large changes in use; improvements were concentrated in low-income, sick individuals; such things as smoking, weight, and cholesterol levels were unaffected by increased encounters with physicians.