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  • Title: Financially catastrophic and high-cost cases: definitions, distinctions, and their implications for policy formulation.
    Author: Wyszewianski L.
    Journal: Inquiry; 1986; 23(4):382-94. PubMed ID: 2947859.
    Abstract:
    To facilitate discourse and improve the formulation of policy, a clear distinction should be made between financially catastrophic and high-cost health care expenditures. I propose that "financially catastrophic" be used to describe cases whose expenditures are large relative to ability to pay (e.g., when out-of-pocket medical expenditures exceed 15% of annual family income) and that "high cost" describe cases whose total expenditures exceed a set amount (e.g., $10,000 in a year's time) regardless of source of payment or ability to pay. Using these distinctions, I show how third-party coverage and other resources determine whether a high-cost case or illness is also financially catastrophic. I illustrate the usefulness of the proposed categorization by applying it to several current policy issues.
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