Asking patients to pay more for health care may not reduce costs, could be harmful to vulnerable populations

Asking patients to share more of the cost of health care may not be an effective tool to reduce the growth rate of spending and could have negative consequences for the health of vulnerable patients, according to a study by HSPH’s Katherine Swartz. Patients are likely to reduce their use of health care services if asked to pay more; however, reductions by the majority of people, who are healthy, would have little effect on lowering overall costs, she wrote.

For more vulnerable populations, such as low-income individuals, the elderly, and the chronically ill, cost-sharing could have negative health consequences. Swartz found that people don’t discriminate between essential and non-essential services when deciding whether or not to cut back. Although patients in the study population reduced the inappropriate use of emergency department services when cost-sharing was increased, they also reduced the use of preventive care and essential drugs.

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Department of Health Policy and Management

Can Cost-Effective Health Care=Better Health Care? (Harvard Public Health Review)

Reining in Health Care Costs (Harvard Public Health Review)