Gruber J, Levitt L
Massachusetts Institute of Technology, USA.
Health Aff (Millwood). 2000 Jan-Feb;19(1):72-85. doi: 10.1377/hlthaff.19.1.72.
The continued rise in the uninsured population has lead to considerable interest in tax-based policies to raise the level of insurance coverage. Using a detailed microsimulation model for evaluating these policies, we find that while tax subsidies could significantly increase insurance coverage, even very generous tax policies could not cover more than a sizable minority of the uninsured population. For example, a generous refundable credit that costs $13 billion per year would reduce the ranks of the uninsured by only four million persons. We also find that the efficiency of tax policies, in terms of the cost per newly insured, inevitably would fall as more of the uninsured were covered.
未参保人口的持续增加引发了人们对基于税收的政策的浓厚兴趣，这些政策旨在提高保险覆盖水平。通过使用一个详细的微观模拟模型来评估这些政策，我们发现，虽然税收补贴可以显著提高保险覆盖率，但即使是非常慷慨的税收政策也无法覆盖超过相当一部分未参保人口。例如，一项每年花费130亿美元的慷慨可退还税收抵免政策，只能使未参保人数减少400万。我们还发现，随着更多未参保者获得保险，从每新增一名参保者的成本来看，税收政策的效率不可避免地会下降。
