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Trends in cost sharing among selected high income countries—2000–2010

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  • Hossein, Zare
  • Gerard, Anderson

Abstract

Many high income countries increased their level of patient cost sharing between 2000 and 2010 as one component of their policy agenda to reduce the level of health care spending. We use data from the OECD, European Observatory, and country-specific resources to analyze trends in the UK, Germany, Japan, France, and the United States. Some forms of cost sharing—deductibles, co-insurance, or co-payments—increased in all these countries, with the highest rates of increase occurring in the pharmaceutical sector. In spite of higher levels of cost-sharing, out-of-pocket spending as a percentage of total spending remained unchanged in most of these countries because they instituted programs to protect certain categories of individuals by creating out-of-pocket limits, exempting people with certain chronic diseases, or eliminating cost sharing for certain demographic groups and low-income people.

Suggested Citation

  • Hossein, Zare & Gerard, Anderson, 2013. "Trends in cost sharing among selected high income countries—2000–2010," Health Policy, Elsevier, vol. 112(1), pages 35-44.
  • Handle: RePEc:eee:hepoli:v:112:y:2013:i:1:p:35-44
    DOI: 10.1016/j.healthpol.2013.05.020
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    References listed on IDEAS

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    1. Gericke, Christian A. & Wismar, Matthias & Busse, Reinhard, 2004. "Cost-sharing in the German health care system," Discussion Papers 2004/4, Technische Universität Berlin, School of Economics and Management.
    2. Lisac, Melanie & Reimers, Lutz & Henke, Klaus-Dirk & Schlette, Sophia, 2010. "Access and choice – competition under the roof of solidarity in German health care: an analysis of health policy reforms since 2004," Health Economics, Policy and Law, Cambridge University Press, vol. 5(01), pages 31-52, January.
    3. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
    4. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896.
    5. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459 Elsevier.
    6. Amitabh Chandra & Jonathan Gruber & Robin McKnight, 2010. "Patient Cost-Sharing and Hospitalization Offsets in the Elderly," American Economic Review, American Economic Association, vol. 100(1), pages 193-213, March.
    7. Katherine Baicker & Dana Goldman, 2011. "Patient Cost-Sharing and Healthcare Spending Growth," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 47-68, Spring.
    8. Valérie Paris & Elizabeth Docteur, 2008. "Pharmaceutical Pricing and Reimbursement Policies in Germany," OECD Health Working Papers 39, OECD Publishing.
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    Cited by:

    1. Vogler, Sabine & Zimmermann, Nina & de Joncheere, Kees, 2016. "Policy interventions related to medicines: Survey of measures taken in European countries during 2010–2015," Health Policy, Elsevier, vol. 120(12), pages 1363-1377.
    2. Takaku, Reo, 2016. "Effects of reduced cost-sharing on children's health: Evidence from Japan," Social Science & Medicine, Elsevier, vol. 151(C), pages 46-55.

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