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Is Patient Cost-Sharing the Best Way to Protect the Medical Commons?
- Anish P. Mahajan, MD, MPH; and
- Robert H. Brook, MD, ScD
- From David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90024, and The RAND Corporation, Santa Monica, CA 90407.
IN RESPONSE:
We thank Dr. Fletcher and colleagues for their thoughtful letter describing HPHC's decision-making process and rationale for providing first-dollar coverage of FOBT, but not colonoscopy, in its high-deductible health plan. The HPHC's ethics advisory group, which engages a range of stakeholders, is laudable.
Dr. Fletcher and colleagues defend HPHC's decision to provide first-dollar coverage for FOBT but not colonoscopy by citing evidence-based guidelines, from the time when the coverage decision was made, that regarded the 2 screening interventions as equally effective. In light …
