Montagne C
Milbank Q. 2002;80(3):547-67, iv. doi: 10.1111/1468-0009.00022.
Before contract negotiations in 1999, the author served on an "issue-based" health benefits committee of faculty union representatives and university administrators. Although the committee solicited estimates from health insurers regarding the impact of higher copayments on monthly premiums, in subsequent negotiations, the projected cost savings did not lead to changes in coverage or copayments. The explanations offered are (1) national or regional employers may be reluctant to raise employees' health benefit copayments when labor markets are tight; (2) collective bargaining, particularly when other, nonmonetary issues are being bargained, may lead to results different from those from a strictly competitive model; and (3) employers with market power in the product market may shift these highest costs to consumers through higher prices.
1999年合同谈判之前，作者曾在一个由教师工会代表和大学管理人员组成的“基于问题”的健康福利委员会任职。尽管该委员会向健康保险公司征求了关于提高自付费用对月度保费影响的估计，但在随后的谈判中，预计的成本节约并未导致保险范围或自付费用的改变。给出的解释如下：（1）当劳动力市场紧张时，全国或地区的雇主可能不愿提高员工的健康福利自付费用；（2）集体谈判，尤其是在谈判其他非货币问题时，可能会产生与严格竞争模型不同的结果；（3）在产品市场上具有市场势力的雇主可能会通过提高价格将这些最高成本转嫁给消费者。
