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Is Patient Cost-Sharing the Best Way to Protect the Medical Commons?
- Robert H. Fletcher, MD, MSc;
- James E. Sabin, MD; and
- Joseph Dorsey, MD
- From Harvard Medical School, Boston, MA 02115.
TO THE EDITOR:
Wharam and colleagues (1) reported that a high-deductible insurance plan providing first-dollar coverage for fecal occult blood tests (FOBTs) but not colonoscopies did not change colorectal cancer screening rates but did result in somewhat higher use of FOBTs and lower use of colonoscopies. The article and accompanying editorial (2) imply that it might be unsound to cover FOBTs but not colonoscopies. However, clinical practice guidelines at the time of the study recommended both tests. These guidelines did not consider either method to be unequivocally superior, but pointed out that they had different …
