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Does free medical care lead to better health than insurance plans that require the patient to shoulder part of the cost? In an effort to answer this question, the authors studied 3,958 people between the ages of 14 and 61 who were free of disability that precluded work and had been randomly assigned to a set of insurance plans for three or five years. One plan provided free care; the others required enrollees to pay a share of their medical bills. As reported in R-2847-HHS, patients in the latter group made approximately one-third fewer visits to a physician and were hospitalized about one-third less often. For persons with poor vision and for low-income persons with high blood pressure, free care brought an improvement (vision better by 0.2 Snellen lines, diastolic blood pressure lower by 3 mm Hg); better control of blood pressure reduced the calculated risk of early death among those at high risk. For the average participant, as well as for subgroups differing in income and initial health status, no significant effects were detected on eight other measures of health status and health habits. Confidence intervals for these eight measures were sufficiently narrow to rule out all but a minimal influence, favorable or adverse, of free care for the average participant. For some measures of health in subgroups of the population, however, the broader confidence intervals make this conclusion less certain.
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Delivery of Health Care --- Health Status. --- Insurance, Health. --- Medical care, Cost of --- -Medical care --- -Insurance, Health --- -Health plans, Prepaid --- Insurance, Health --- Medical care, Prepaid --- Medical insurance --- Prepaid health plans --- Prepaid medical care --- Sickness insurance --- Insurance --- Ambulance service --- Health care reform --- Home care services --- Hospitals --- Medically uninsured persons --- Surgical clinics --- Delivery of health care --- Delivery of medical care --- Health care --- Health care delivery --- Health services --- Healthcare --- Medical and health care industry --- Medical services --- Personal health services --- Public health --- Cost of medical care --- Health care costs --- Health care expenditures --- Medical care --- Medical costs --- Medical expenses --- Medical service, Cost of --- Medicine --- Medical economics --- Medical savings accounts --- Group Health Insurance --- Health Insurance --- Health Insurance, Voluntary --- Health Insurance, Group --- Insurance, Group Health --- Insurance, Voluntary Health --- Voluntary Health Insurance --- Level of Health --- Health Level --- Health Levels --- Status, Health --- economics. --- Utilization --- Research --- -Coinsurance --- Prospective payment --- Emergency services --- Outpatient services --- Rehabilitation services --- Costs --- Rand Health Insurance Experiment --- HIE --- H.I.E. --- Health Insurance Experiment (Rand Corporation) --- United States. --- -economics. --- Health coinsurance --- Health insurance --- Health Status --- Health plans, Prepaid --- Coinsurance --- economics --- Rand Health Insurance Experiment. --- Medical care [Cost of ] --- United States --- Insurance [Health ] --- Medical care - United States - Utilization. --- Insurance, Health - Research - United States. --- Insurance, Health - United States - Coinsurance. --- General Health --- General Health Level --- General Health Status --- Overall Health --- Overall Health Status --- General Health Levels --- Health Level, General --- Health Status, General --- Health Status, Overall --- Health, General --- Health, Overall --- Level, General Health --- Levels, General Health --- Status, General Health --- Status, Overall Health
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