Health Care Costs

The Consequences of Increased Cost Sharing

by Charles E. Phelps


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This report analyzes the possible distributional consequences of several government policies for controlling health care costs. Drawing on the results of RAND's Health Insurance Study, it evaluates the potential savings from policies designed to increase cost sharing — deductibles and copayments — in both government and employer financed health insurance programs. It then examines how the cost of realizing these savings is distributed among major actors in the health care system — patients, doctors, hospitals, suppliers, insurers, and state and federal governments. The study assesses consequences of specific proposals to increase income taxation of employer financed insurance programs and to increase copayments in Medicaid.

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