Abstract
From 1971 to 1982, the RAND Health Insurance Experiment (HIE) in the United States randomly allocated families to health insurance plans with zero, 25%, 50% or 95% copayments.2 The study found that “Cost sharing in general had no adverse effects on participant health”. This finding might support a copayment. However, the study also provides evidence against copayments by emphasising the finding that “The poorest and sickest 6 percent of the sample at the start of the experiment had better outcomes under the free plan for 4 of the 30 conditions measured”.
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