A recent study in the Journal of General Internal Medicine may have the answer to the question - Will those who currently have health insurance be willing to sacrifice in order to insure the millions of people who do not? The findings suggest that the answer may in fact be yes.

To explore whether the insured would help cover the uninsured, researchers asked 322 insured people to play a board game with a focus on health and insurance. Called CHAT, for Choosing Healthplans All Together, the game gives players a limited number of pegs to allocate to many categories of insurance coverage, including funding to cover the uninsured. Randomly drawn cards representing health problems and crises show players how the plan they designed would work in the case of an illness or injury to themselves or others.

The study demonstrated that when groups of citizens deliberate on this issue, even those with insurance recognize and are willing to accept tradeoffs between having more generous benefits and having coverage for all. During deliberations, individuals voiced sophisticated, cogent arguments for and against giving up some of their benefits to include the uninsured. For example, corresponding author and CHAT co-inventor Susan Dorr Goold notes "For many, choosing this coverage was viewed as insuring themselves against becoming uninsured."

Dr. Goold and the coauthors of this study received the 2002 Mark S. Ehrenreich Prize for Research in Healthcare Ethics for the work reported in this paper.

About the Author

Susan Dorr Goold, M.D., MHSA, M.A., is an Associate Professor of Internal Medicine at the University of Michigan Medical School and Director of its Bioethics Program. Dr. Goold, whose work was supported by the Robert Wood Johnson Foundation, and her co-inventor, Marion Danis were awarded the Paul Ellwood Award from the Foundation of Accountability (FACCT) and the Mark S. Ehrenreich Prize for Research in Healthcare Ethics. Dr. Goold is available for questions and interviews and can be reached at sgoold@umich.edu or 734-936-5222.

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About the Journal of General Internal Medicine

The Journal of General Internal Medicine (JGIM) is the official scientific publication of the Society of General Internal Medicine, whose mission is to promote improved patient care, research, and education in primary care and general internal medicine. JGIM articles focus on topics such as clinical research, curriculum development, epidemiology, prevention, and health care delivery in general internal medicine.

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