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. Author manuscript; available in PMC: 2010 Sep 13.
Published in final edited form as: Health Policy. 2000 Sep;53(2):105–121. doi: 10.1016/s0168-8510(00)00085-3
 1. Many women get mammograms free of charge. But suppose that there was no way to get a free mammogram. Would you get a mommogram if it cost $75?
1. Yes GO TO 2
2. No GO TO 5
3. {DON’T READ} NO, WOULD NOT PAY ANYTHING STOP, End Qx
7. {DON’T READ} NOT APPLICABLE GO TO 8
8. {DON’T READ} REFUSED GO TO 8
 2. Would you be willing to pay $100 for a mammogram?
1.     Yes GO TO 3
2.     No STOP, End Qx
 3. Would you be willing to pay $125?
1.     Yes GO TO 4
2.     No STOP, End Qx
 4. Would you be willing to pay $150?
1.     Yes GO TO 8
2.     No STOP, End Qx
 5. Would you be willing to pay $50 for a mammogram?
1.     Yes STOP, End Qx
2.     No GO TO 6
 6. Would you be willing to pay $25?
1.     Yes STOP, End Qx
2.     No GO TO 7
 7. Would you be willing to pay $10?
1.     Yes STOP, End Qx
2.     No GO TO 8
 8. What is the most money that you would be willing to pay to get a mammogram? (PROBE): Considering what you can afford right now, what is the most money that you would be willing to pay for a mammogram?
 INTERVIEWER: Payment for routine mammograms only
AMOUNT (dollars) (Logical range = 0–500)
 Willingness to travel
 1. Suppose that there was a clinic offering free mammograms. However, in order to get a mammogram, you would have to travel to the clinic. If you had to travel 2 h each way, would you make the trip for the free mammogram?
 INTERVIEWER: Travel for routine mammograms only
1. Yes GO TO 2
2. No GO TO 5
3. {DON’T READ} NO, WOULD NOT TRAVEL STOP, End,Qx
7. {DON’T READ} NOT APPLICABLE GO TO 8
8. {DON’T READ} DON’T KNOW:NOT SURE GO TO 8
9. {DON’T READ} REFUSED GO TO 8
 2. Would you travel 2.5 h each way for a free mammogram?
1.     Yes GO TO 3
2.     No STOP, End Qx
 3. Would you travel 3 h each way?
1.     Yes GO TO 4
2.     No STOP, End Qx
 4. Would you travel 3.5 h each way?
1.     Yes GO TO 8
2.     No STOP, End Qx
 5. Would you travel 1.5 h each way for a free mammogram?
1.     Yes STOP, End Qx
2.     No, GO TO 6
 6. Would you travel 1 h each way?
1.     Yes STOP, End Qx
2.     No GO TO 7
 7. Would you travel 0.5 h each way?
1.     Yes STOP, End Qx
2.     No GO TO 7
 8. What is the most amount of time you would be willing to travel — each way — to get a free mammogram?
HS (each way) (Logical range = 0–10)
MINS (each way) (Logical range = 0–59)
 9995. {DON’T READ} NO, WOULD NOT TRAVEL
 9996. {DON’T READ} NO LIMIT, WOULD TRAVEL HOWEVER LONG IT TAKES
 9997. {DON’T READ} NOT APPLICABLE
 9998. {DON’T READ} DON’T KNOW:NOT SURE
 9999. {DON’T READ} REFUSED