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ARTICLE |

COMPREHENSIVE OR "SINGLE PLAN MAJOR MEDICAL" INSURANCE

Elmer Hess, M.D.
JAMA. 1958;166(5):472-476. doi:10.1001/jama.1958.02990050042008.
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ABSTRACT

The advantages of a comprehensive plan for medical insurance are illustrated by the experience of a company with 315,000 employees. More than 98% of the employees participate in the plan, which involves dependents to a total of about three-quarters of a million people. Outstanding features of the plan are the wide coverage of expenses incidental to sickness, accident, and disability, the administrative economy affected by a $25-deductible provision, and the enlistment of the patient's personal economic interest in the amount and cost of the care he receives by having him pay 15% of the excess of certain types of expenses above $225. The policies automatically take into account the normal variations of geography, complications, and so on which inevitably affect what physicians, hospitals, nurses, or druggists must charge, and the philosophy back of this plan continues to reflect the principles of free enterprise. It deserves study as illustrating the possibility of meeting the nation's health needs by voluntary cooperation of patients, physicians, and all others involved, and is presented for the information of the profession.

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