Economic Class and Risk Avoidance: Experience under Public Medical Care Insurance

This paper presents data on benefit distributions for physicians' services insured under a public universal medical care insurance plan in the Province of Saskatchewan, Canada. Characteristics of the distributions are discussed and their policy implications are examined. The conclusion is that mean dollar benefits are directly related to family income, while the relative variability of benefits is inversely related to family income. In addition, modest deductibles would have the effect of shifting a substantial proportion of program costs to beneficiaries. The temporal uncertainty of an individual's demand for medical care has long been recognized as the rationale for insurance arrangements in the health field. Recent consensus that health care is essential has given rise to the social ethic of a right to health care. Accordingly, some form of national health insurance is now a feature of the health care delivery system in most western countries. An important element in the evaluation of a public universal medical care insurance program is the extent to which it provides a vehicle for risk avoidance by certain soci -economic groups.