Gabel Jon, Pickreign Jeremy, McDevitt Roland, Whitmore Heidi, Gandolfo Laura, Lore Ryan, Wilson Katy
NORC, Washington, DC, USA.
Health Aff (Millwood). 2007 Jul-Aug;26(4):w488-99. doi: 10.1377/hlthaff.26.4.w488. Epub 2007 Jun 14.
Using multiple databases, this paper examines recent trends in the affordability and comprehensiveness of small-group and individual health insurance markets in California. Both became less affordable over the study period. In 2006, a single person age 32-52 earning the median income who purchased individual insurance spent on average 16 percent of income on premiums and out-of-pocket medical expenses. For individual insurance, the share of medical expenses paid by insurance as opposed to patients declined from 2002 to 2006. In the small-group market, premiums rose more than 50 percent from 2003 to 2006, but the proportion of claims paid by insurers for a standardized population remained constant.
本文通过使用多个数据库，研究了加利福尼亚州小团体和个人健康保险市场在可负担性和全面性方面的近期趋势。在研究期间，这两个市场的可负担性均有所下降。2006年，一名年龄在32至52岁之间、收入中位数的单身人士购买个人保险时，平均将收入的16%用于支付保费和自付医疗费用。对于个人保险，2002年至2006年期间，保险支付的医疗费用份额相对于患者支付的份额有所下降。在小团体市场，2003年至2006年期间保费上涨超过50%，但保险公司为标准化人群支付的理赔比例保持不变。
