Patient Cost Sharing: Understanding Health Policy

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In an attempt to reduce the strain on the healthcare system, the notion of patient cost sharing was introduced. It has its own positive and negative effects on the healthcare system, which I will discuss in this paper. Out-of-pocket payments are usually met with discontent and could be ignorantly referred to the government incompetence. To understand their necessity, I will address the benefits of cost sharing first.

Experiments were conducted to determine the role the patient cost sharing system plays in inappropriate use of emergency services and have shown that, in modest amounts, it is a painless form of cost control (Bodenheimer & Grumbach, 2016). It is designed to encourage people to use appropriate healthcare services only when needed and if needed. This increased financial awareness from patients provides more stable support for healthcare finances, which is necessary for the healthcare system to function.

First and foremost, these expenditures must be affordable to anyone who is sick and needs medical attention. However, the balance is yet to be found and even nowadays sick people with low income can find themselves unable to afford the required treatment. Even worse, high costs could serve as a deciding factor for taking proper care of a chronic illness (Bodenheimer & Grumbach, 2016).

High out-of-pocket payments could lead to more expenditures in the future, which could be a disastrous case of snowballing for a patient. Bodenheimer and Grumbach (2016) suggest that patient cost sharing should not be applied to low-income patients and designed to encourage patients to use lower-cost alternative sources of care (p. 203). I believe that access to the healthcare system should be equally affordable to anyone who is in need of its services.

Reference

Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill.

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