Russo Gerard
University of Hawaii, Department of Economics, Saunders Hall, Room 515B, 2424 Maile Way, Honolulu, HI 98822, USA.
Int J Health Care Finance Econ. 2003 Mar;3(1):53-71. doi: 10.1023/a:1023272032586.
The optimal public insurance-taxation scheme is derived for a model with unobservable outcomes. If the government can only observe aggregate commodity expenditures, reimbursement insurance is constrained-efficient. However, two distortions accompany the reimbursement scheme. First, consumers are induced to take (forego) actions which increase (decrease) the likelihood of adverse outcomes (i.e., ex ante moral hazard). Second, reimbursement insurance creates a subsidy distortion (i.e., ex post moral hazard). Ex ante moral hazard calls for taxation (subsidization) of commodities which increase (decrease) the probability of adverse outcomes. The second distortion calls for taxation (subsidization) of commodities which are sufficiently strong complements to (substitutes for) the insured commodity. An example centered on cigarettes and medical insurance is presented.
针对一个结果不可观测的模型,推导了最优公共保险-税收方案。如果政府只能观测到总体商品支出,报销保险是受限有效的。然而,报销方案伴随着两种扭曲。首先,消费者会被诱导采取(放弃)那些增加(降低)不良结果可能性的行动(即事前道德风险)。其次,报销保险会造成补贴扭曲(即事后道德风险)。事前道德风险要求对那些增加(降低)不良结果概率的商品征税(给予补贴)。第二种扭曲要求对与被保险商品有足够强互补性(替代性)的商品征税(给予补贴)。给出了一个以香烟和医疗保险为核心的例子。