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March 23, 1994

Do Health Care Premiums Affect Patient Enrollment?-Reply

Author Affiliations

UCLA School of Public Health Los Angeles, Calif

JAMA. 1994;271(12):902-903. doi:10.1001/jama.1994.03510360026019

In Reply.  —No one can know how responsive consumers will be to premium differences between health insurance plans under managed competition. We based our conclusion that response will not be very high on a review of existing econometric studies, which was conducted by the Congressional Budget Office (internal memorandum, March 17, 1993). Although Dr Barr's data are noteworthy, three things should be pointed out.First, the Kaiser data provide a study of just one health plan, hardly enough evidence from which to draw important policy implications. Second, there is no certainty that there is a causal relationship between enrollment and premium differences. Many other variables must be controlled for before making any definitive conclusions from the data Barr presents. These include indicators of changes in the benefits offered by Kaiser and its competitors, changes in cost-sharing requirements, and changes in consumers' perceptions of the quality of care provided by alternative

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