Bakker F M, van Vliet R C, van de Ven W P
Department of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
Health Policy. 2000 Sep;53(2):123-41. doi: 10.1016/s0168-8510(00)00083-x.
The actuarially fair premium reduction in case of a deductible relative to full insurance is affected by: (1) out-of-pocket payments, (2) moral hazard, (3) administrative costs, and, in case of a voluntary deductible, (4) adverse selection. Both the partial effects and the total effect of these factors are analyzed. Moral hazard and adverse selection appear to have a substantial effect on the expected health care costs above a deductible but a small effect on the expected out-of-pocket expenditure. A premium model indicates that for a broad range of deductible amounts the actuarially fair premium reduction exceeds the deductible.
与全额保险相比，免赔情况下精算公平保费的降低受以下因素影响：（1）自付费用；（2）道德风险；（3）管理成本；对于自愿性免赔情况，还受（4）逆向选择影响。本文分析了这些因素的部分效应和总体效应。道德风险和逆向选择似乎对免赔额以上的预期医疗费用有重大影响，但对预期自付支出影响较小。一个保费模型表明，对于广泛的免赔额范围，精算公平保费的降低超过了免赔额。
