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Consumer-Directed Health Care And The Disadvantaged
M. Gregg Bloche
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]
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