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An age-old question: Would universal access result in higher costs from those less in need?

Few doubt that universal coverage would have an impact on use of health care services, but just who would use them is subject to debate. A U.S. Agency for Health Care Policy and Research study of the potential effects on behavioral health utilization suggests that expanding coverage would not only induce those with mental illnesses and substance-abuse problems to use more services, but those without any such problems would also do so — perhaps disproportionately. As for policy implications, the researcher notes that even when this model is limited to granting universal coverage to those whose incomes are up to 200 percent of poverty, utilization increases similar to those suggested here would result.

SOURCE: INQUIRY, BLUE CROSS AND BLUE SHIELD OF THE ROCHESTER AREA, SUMMER 1999

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