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Other studies of cost sharing examining acutely ill individuals have also failed to observe any negative health effect from cost sharing.[20] [Click on the footnote for some limitations of the study.] * Among developed nations, greater household disposable income is generally associated with higher healthcare spending.

This is mandated under a federal law called the Emergency Medical Treatment and Active Labor Act (EMTALA).[90] [91] [92] * In 2000, emergency room physicians incurred an average of $138,300 in bad debt by providing treatment mandated under EMTALA.

Moreover, the additional expense that comes from being admitted to a relatively costly hospital is also fully insured, or nearly so.

Thus, neither patients nor physicians have much incentive to choose an economically efficient rather than an inefficient hospital, or to economize on services once a patient is admitted….[19] (2001) analyzed insurance coverage levels and health outcomes of “an older, chronically ill population” with conditions such as “diabetes, hypertension, coronary artery disease, congestive heart failure, or depression.” The study grouped “individuals into 3 cost-sharing categories: no copay (insurance pays all), low copay (insurance pays more than half but not all), and high copay (insurance pays half or less).” Per the study: We found no association between cost sharing and health status at baseline or follow-up.

It includes any payment to an ineligible recipient, any payment for an ineligible service, any duplicate payment, payments for services not received….[72] * In 2011, GAO reported the results of an investigation meant to “determine the extent to which Medicare beneficiaries obtained frequently abused drugs from multiple prescribers.” This is sometimes called “doctor shopping,” and it is one of the primary ways in which people “obtain highly addictive” prescription drugs “for illegitimate use.” The investigation found that: about 170,000 Medicare beneficiaries received prescriptions from five or more medical practitioners for the 12 classes of frequently abused controlled substances and 2 classes of frequently abused noncontrolled substances in calendar year 2008.