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Traditionally, Americans have obtained individual and family health insurance coverage in one of three ways. Some have been covered by public programs (Medicaid for the very poor, Medicare for the elderly), and some have paid directly for policies, but by far the largest number of people have obtained health coverage in the form of group insurance provided through their employers. Insurance programs for members of large groups have had the lowest prices. In most cases, however, low prices have not been extended to small employee groups or to individuals. This aspect of health insurance structure has had adverse financial effects . . .
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Freedman et al. (1988) studied this question.
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