Hall M A
Wake Forest University, School of Medicine, Department of Public Health Sciences, Winston-Salem, NC 27157-1063, USA.
Milbank Q. 2000;78(1):23-45, i-ii. doi: 10.1111/1468-0009.00160.
The impact of reforms on the health insurance markets cannot be understood without more information about the role played by insurance agents and a closer analysis of their contribution. An in-depth, qualitative study of insurance-market reforms in seven illustrative states forms the basis for this report on how agents help to shape the efficiency and fairness of insurance markets. Different types of agents relate to insurers in their own ways and are compensated differently. This study shows agents to be almost uniformly enthusiastic about guaranteed-issue requirements and other components of market reforms. Although insurers devise strategies for manipulating agents in order to avoid undesirable business, these opportunities are limited and do not appear to be seriously undermining the effectiveness of market reforms. Despite the layer of cost that agents add to the system, they play an important role in making market reforms work, and they fill essential information and service functions for which many purchasers have no ready substitute.
如果没有更多关于保险代理人所起作用的信息以及对其贡献的更深入分析，就无法理解改革对健康保险市场的影响。对七个具有代表性的州的保险市场改革进行的深入定性研究，构成了本报告关于代理人如何帮助塑造保险市场效率和公平性的基础。不同类型的代理人与保险公司的关系各不相同，薪酬方式也有所不同。本研究表明，代理人几乎一致对保证发行要求和市场改革的其他组成部分充满热情。尽管保险公司制定策略来操纵代理人以避免不良业务，但这些机会有限，似乎并未严重削弱市场改革的有效性。尽管代理人给系统增加了一层成本，但他们在使市场改革发挥作用方面发挥着重要作用，并且他们履行了许多购买者没有现成替代方案的基本信息和服务功能。
