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Comment & Response
April 17, 2018

Measures of the Burden of Medical Expenses—Reply

Author Affiliations
  • 1Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia
  • 24Sight Health, Chicago, Illinois
JAMA. 2018;319(15):1621-1622. doi:10.1001/jama.2018.1327

In Reply No summary measure is perfect. For instance, gross domestic product and poverty rates have been used for decades, despite persistent debate over how well these indices assess the economy and the correct way to measure them. The gross domestic product does not include parents’ uncompensated caregiving of children, which is vital to a healthy society. Despite their flaws, such measures serve invaluable functions.

A simple, reliable, and valid measure of affordability is critical to keeping the issue of financial burden for families at the center of discussions between policy makers, physicians, hospital and insurance executives, and other actors in health care. Although imperfect, the Affordability Index fulfills this function.