Cutler David M, Gruber Jonathan, Hartman Raymond S, Landrum Mary Beth, Newhouse Joseph P, Rosenthal Meredith B
Department of Economics, Harvard University, USA.
J Policy Anal Manage. 2002 Winter;21(1):1-19. doi: 10.1002/pam.1037.
Recent litigation against the major tobacco companies culminated in a master settlement agreement (MSA) under which the participating companies agreed to compensate most states for Medicaid expenses. Here the terms of the settlement are outlined and its economic implications analyzed using data from Massachusetts. The financial compensation to Massachusetts (and other states) under the MSA is substantial. However, this compensation is dwarfed by the value of the health impacts induced by the settlement. Specifically, Medicaid spending will fall, but only by a modest amount. More importantly, the value of health benefits ($65 billion through 2025 in 1999 dollars) from increased longevity is an order of magnitude greater than any other impacts or payments. The net efficiency implications of the settlement turn mainly on a comparison of the value of these health benefits relative to a valuation of the foregone pleasure of smoking. To the extent that the value of the health benefits is not offset by the value of the pleasure foregone, the economic impacts of the MSA will include a share of these health benefits.
近期针对各大烟草公司的诉讼最终达成了一项《主和解协议》（MSA），根据该协议，参与的公司同意就医疗补助费用向大多数州进行赔偿。本文概述了和解条款，并利用马萨诸塞州的数据对其经济影响进行了分析。根据《主和解协议》，马萨诸塞州（以及其他州）获得的经济赔偿数额巨大。然而，与和解所带来的健康影响的价值相比，这笔赔偿就显得微不足道了。具体而言，医疗补助支出将会下降，但降幅不大。更重要的是，因寿命延长而带来的健康益处的价值（以1999年美元计算，到2025年为650亿美元）比任何其他影响或支付都要高出一个数量级。和解协议的净效率影响主要取决于对这些健康益处的价值与放弃吸烟所带来的愉悦感的估值之间的比较。在健康益处的价值没有被放弃的愉悦感的价值抵消的程度上，《主和解协议》的经济影响将包括这些健康益处的一部分。
