Cover: The Effects of Insurance Generosity on the Psychological Distress and Well-Being of a General Population

The Effects of Insurance Generosity on the Psychological Distress and Well-Being of a General Population

Results from a Randomized Trial of Insurance

Published 1989

by Kenneth B. Wells, Willard G. Manning, R. Burciaga Valdez


Download eBook for Free

FormatFile SizeNotes
PDF file 1.5 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.


Purchase Print Copy

 Format Price
Add to Cart Paperback46 pages $20.00

Reductions in the generosity of fee-for-service insurance lower the use of general medical and mental health services, but do they lead to lower mental health for the covered population? The authors addressed this question using data from the RAND Health Insurance Experiment. Families in six U.S. sites were randomly assigned to one of 14 insurance plans for three- or five-year periods. On average, there were no significant adverse effects of cost-sharing plans, relative to a free-care plan, on either psychological well-being or psychological distress, when the cost-sharing plans included full catastrophic coverage. Those with high mental health status but low income at baseline had significantly more favorable mental health outcomes on the cost-sharing plans than on the free-care plan. The authors cannot definitively comment on the effects of insurance generosity for the sick poor. Their findings apply in the context of mandated comprehensive mental and general health coverage for a general nonelderly, nondisabled household population.

This report is part of the RAND report series. The report was a product of RAND from 1948 to 1993 that represented the principal publication documenting and transmitting RAND's major research findings and final research.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.