Di Matteo L
Department of Economics, Lakehead University, Thunder Bay, Canada.
Health Policy. 2000 Jun;52(2):87-112. doi: 10.1016/s0168-8510(00)00071-3.
The health care policy issue regarding the balance between public and private health spending is examined. An empirical model of the determinants of the public-private mix in Canadian health care expenditures over the period 1975-1996 is estimated for total health care expenditures as well as separate expenditure categories such as hospitals, physicians and drugs. The results find that the key determinants of the split are per capita income, government transfer variables and the share of individual income held by the top quintile of the income distribution. Much of the public-private split is determined by long term economic forces. However, the importance of the federal health transfer variables and the variables representing shifts in fiscal transfer regimes suggest the increase in the private share of health spending since 1975 is also partly the result of the policy choice to reduce federal health transfers.
本文探讨了医疗卫生政策中关于公共与私人医疗支出平衡的问题。针对1975年至1996年期间加拿大医疗支出中公共-私人混合比例的决定因素，构建了一个实证模型，该模型分别针对医疗总支出以及医院、医生和药品等不同支出类别进行估计。结果发现，决定支出比例的关键因素包括人均收入、政府转移支付变量以及收入分配中最高五分之一人群的个人收入份额。公共与私人支出比例的很大一部分由长期经济因素决定。然而，联邦医疗转移支付变量以及代表财政转移支付制度变化的变量的重要性表明，自1975年以来私人医疗支出份额的增加，部分也是减少联邦医疗转移支付这一政策选择的结果。
