Health Affairs, 26, no. 5 (2007): 1315-1327 doi: 10.1377/hlthaff.26.5.1315 © 2007 by Project HOPE	New Online   Pay Cuts For Medicare Docs   Access To Care Woes   Public Coverage More Efficient   Empowering Consumers

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Health System

Consumer-Directed Health Care And The Disadvantaged

Broad adoption of "consumer-directed health care" would probably widen socioeconomic disparities in care and redistribute wealth in "reverse Robin Hood" fashion, from the working poor and middle classes to the well-off. Racial and ethnic disparities in care would also probably worsen. These effects could be alleviated by adjustments to the consumer-directed paradigm. Possible fixes include more progressive tax subsidies, tiering of cost-sharing schemes to promote high-value care, and reduced cost sharing for the less well-off. These fixes, though, are unlikely to gain traction. If consumer-directed plans achieve market dominance, disparities in care by class and race will probably grow.

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				K. Baicker, W. H. Dow, and J. Wolfson Lowering The Barriers To Consumer-Directed Health Care: Responding To Concerns Health Aff., September 1, 2007; 26(5): 1328 - 1332. [Abstract] [Full Text] [PDF]