Gabel Jon R, Long Stephen H, Marquis M Susan
Health Research and Education Trust, USA.
Med Care Res Rev. 2002 Dec;59(4):440-54. doi: 10.1177/107755802237810.
The authors examine the generosity of private employer health insurance coverage using data from two large national surveys of employers. Generosity is measured as the expected out-of-pocket share of medical expenditures for a standard population, given the provisions of the coverage. On average, those covered by employer-sponsored insurance can expect to pay 25 percent of expenditures out of pocket. There is little variability across plans in this share, though plans offered by smaller employers are somewhat less generous than those offered by larger employers. Individuals who incur high costs pay a smaller share of the bill than do those with lower levels of spending. The generosity of employer-sponsored plans increased slightly in the 1990s.
作者利用两项针对雇主的大型全国性调查数据，研究了私人雇主医疗保险覆盖范围的慷慨程度。慷慨程度根据保险条款，以标准人群医疗支出的预期自付比例来衡量。平均而言，参加雇主赞助保险的人预计自付支出的25%。这一比例在不同计划之间差异不大，不过小雇主提供的计划不如大雇主提供的计划慷慨。高成本人群支付的账单比例低于低支出人群。雇主赞助计划的慷慨程度在20世纪90年代略有增加。
