(De)constructing 'basic' benefits: citizens define the limits of coverage.
Many initiatives for covering the uninsured call for "basic" health care coverage, yet few define that term. The Just Coverage project used a computer-based simulation exercise to learn how nearly 800 community members in northern California identified the inclusions and exclusions that would constitute basic coverage. Working with a limited budget, participants distinguished essential from nonessential health care needs, resisted high patient cost sharing, and tolerated tight restrictions on provider choice. They also supported practice guidelines and standards of effectiveness, and they excluded high-cost, low-value interventions. These results reinforce the importance of community input to policymakers.
Ginsburg
Marjorie
M
Sacramento Healthcare Decisions in Rancho Cordova, California, USA. ginsburg@sacdecisions.org
Goold
Susan Dorr
SD
Danis
Marion
M
D000206:Actuarial Analysis; D002140:California; D018672:Community Health Planning / Q000379:methods*; D003256:Community Participation; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D004608:Eligibility Determination; D017144:Focus Groups; D006292:Health Priorities / Q000145:classification* / Q000191:economics; D006301:Health Services Needs and Demand / Q000145:classification* / Q000191:economics; D006801:Humans; D019458:Insurance Coverage / Q000145:classification*; D017057:Medically Uninsured; D010865:Pilot Projects; D011050:Policy Making