Savage Elizabeth, Wright Donald J
CHERE, University of Technology, Sydney, NSW, Australia.
J Health Econ. 2003 May;22(3):331-59. doi: 10.1016/S0167-6296(02)00104-2.
The Australian hospital system is characterized by the co-existence of private hospitals, where individuals pay for services and public hospitals, where services are free to all but delivered after a waiting time. The decision to purchase insurance for private hospital treatment depends on the trade-off between the price of treatment, waiting time, and the insurance premium. Clearly, the potential for adverse selection and moral hazard exists. When the endogeneity of the insurance decision is accounted for, the extent of moral hazard can substantially increase the expected length of a hospital stay by a factor of up to 3.
澳大利亚的医院系统的特点是私立医院和公立医院并存,在私立医院个人需为服务付费,而在公立医院服务对所有人免费,但需等待一段时间后才能获得。是否购买私立医院治疗保险的决定取决于治疗价格、等待时间和保险费之间的权衡。显然,存在逆向选择和道德风险的可能性。当考虑到保险决策的内生性时,道德风险的程度可能会使医院住院预期时长大幅增加,增幅可达三倍。