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June 13, 2007

Why Well-Insured Patients Should Demand Value-Based Insurance Benefits

Author Affiliations

Author Affiliations: Department of Bioethics, The NIH Clinical Center, National Institutes of Health, Bethesda, Md.

JAMA. 2007;297(22):2515-2518. doi:10.1001/jama.297.22.2515

Variations on the familiar refrain “costs should not factor into decisions about health care” permeate contemporary discussions on the state of the US health care system.1 The US populace seems to strongly agree with this proposition: a 2003 poll indicated that 86% of US citizens do not support the denial of health services for reasons of cost.2 A significant part of this resistance can be attributed to the general feeling that health care services are a special good, the provision of which should not be “unfairly” influenced by costs.3 In particular, patients with good health benefits often suspect they personally have nothing to gain—and much to lose—by integrating costs into coverage determinations.