NEJM October 2, 2024
The meaning of “affordability” is both obvious and nuanced. In general, health care’s affordability depends on the value of what could have been purchased instead (the opportunity cost). Care is less affordable if people must give up basic needs to use more health care than if they merely have to cut back on unessential items. There are then two related dimensions of that opportunity cost that determine how society views and experiences the system’s overall affordability.
The first is its distribution across households. An essential element of affordable health care is a system of health insurance that subsidizes low-income households whose members would otherwise face the worst consequences if they developed costly health care needs. Since affordability crises resulting...
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