Cost Sharing for Health Care — Whose Skin? Which Game?

In this issue of the Journal, Trivedi and colleagues1 examine the effect of cost sharing on the use of screening mammography among women enrolled in Medicare managed-care plans from 2001 to 2004. Focusing on more than 350,000 women between the ages of 65 and 69 years, the authors show that cost sharing — either in the form of copayments (in which patients pay flat fees when they receive services) or coinsurance (in which patients pay a fixed percentage of the cost of those services) — reduces the number of women who undergo mammography. The effects are large relative to the . . .