McCormack L A, Fox P D, Rice T, Graham M L
Center for Health Economics Research, Waltham, MA 02154, USA.
Health Care Financ Rev. 1996 Fall;18(1):157-74.
The 1990 medigap reform legislation had multiple objectives: To simplify the insurance market in order to facilitate policy comparison, provide consumer choice, provide market stability, promote competition, and avoid adverse selection. Based on case study interviews with a cross-section of individuals and organizations, we report that most of these objectives have been achieved. Consumers of medigap plans are able to make more informed choices, largely because they can adequately compare policies based on standard benefits. Marketing abuses have apparently declined, as evidenced by a decrease in the number of consumer complaints. Finally, no major detrimental impact on the insurance industry was detected. Beneficiaries still face some confusion in this market, however, such as understanding the rating methodologies used to set premiums and how this may affect their choices. Confusion could increase with the growth of managed care options.
1990年的医保补充改革立法有多个目标：简化保险市场以方便政策比较、提供消费者选择、确保市场稳定、促进竞争并避免逆向选择。基于对不同个人和组织的案例研究访谈，我们报告称这些目标大多已实现。医保补充计划的消费者能够做出更明智的选择，这很大程度上是因为他们可以根据标准福利充分比较不同政策。营销滥用现象显然有所减少，消费者投诉数量的下降就是证明。最后，未发现对保险业有重大不利影响。然而，受益人在这个市场中仍然面临一些困惑，比如理解用于设定保费的评级方法以及这可能如何影响他们的选择。随着管理式医疗选项的增加，困惑可能会加剧。
