Wyszewianski L
Inquiry. 1986 Winter;23(4):382-94.
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.
为便于进行讨论并改进政策制定，应明确区分造成经济灾难的医疗支出和高成本医疗支出。我建议用“造成经济灾难的”来描述那些支出相对于支付能力而言数额巨大的情况（例如，自付医疗费用超过家庭年收入的15%时），用“高成本的”来描述那些总支出超过设定金额（例如，一年时间内达到1万美元）的情况，而不考虑支付来源或支付能力。通过这些区分，我展示了第三方保险和其他资源如何决定一个高成本病例或疾病是否也会造成经济灾难。我通过将其应用于几个当前的政策问题来说明所提议分类的实用性。
