Duckett S J, Jackson T J
School of Public Health, La Trobe University, Melbourne, Vic.
Med J Aust. 2000 May 1;172(9):439-42. doi: 10.5694/j.1326-5377.2000.tb124043.x.
Private health insurance subsidy is now estimated to cost $2.19 billion; government support for private health care includes a further $1.2 billion of Medicare benefits expenditure in hospitals. The subsidy cannot be justified on efficiency grounds, as, on the basis of available evidence and taking casemix into account, public hospitals are more efficient than private hospitals. The original stated objective of the subsidy was to "take pressure off public hospitals". If the insurance subsidy and the Medicare Benefit Schedule rebate expenditure were applied to purchasing public hospital treatment at full average cost, 58% of current private sector demand could be accommodated. If 10% of the demand were met at marginal cost, this would increase to 65%. The objective of "taking pressure off public hospitals" could be more efficiently achieved by direct funding of public hospitals rather than through subsidies for private health insurance.
目前，私人医疗保险补贴估计耗资21.9亿澳元；政府对私人医疗保健的支持还包括在医院方面额外支出12亿澳元的医疗保险福利。从效率角度来看，这种补贴是不合理的，因为根据现有证据并考虑病例组合情况，公立医院比私立医院更有效率。补贴最初设定的目标是“减轻公立医院的压力”。如果将保险补贴和医疗保险福利计划回扣支出用于按平均全成本购买公立医院治疗服务，那么当前私营部门需求的58%可以得到满足。如果按边际成本满足10%的需求，这一比例将增至65%。通过直接为公立医院提供资金，而不是通过补贴私人医疗保险，能够更有效地实现“减轻公立医院压力”这一目标。
