Pauly Mark V, Pagán José A
Department of Health Care Systems, Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
Health Aff (Millwood). 2007 Sep-Oct;26(5):1304-14. doi: 10.1377/hlthaff.26.5.1304.
This paper studies the uninsured as a vulnerable population. We contend that reducing the size of the uninsured population yields important spillover benefits to the insured population, benefits that go beyond a lower charity care burden. Evidence presented in this paper reinforces studies in the literature that show that problems of health services quality and access facing insured people increase when the proportion of uninsured people in their local communities is greater. The size of such spillover benefits is reduced if the local market is large enough to be segmented based on insurance status.
本文将未参保人群作为弱势群体进行研究。我们认为，减少未参保人群的规模会给参保人群带来重要的溢出效益，这些效益不仅仅是减轻慈善医疗负担。本文所呈现的证据强化了文献中的研究，这些研究表明，当当地社区未参保人群的比例较高时，参保人群面临的医疗服务质量和可及性问题会增加。如果当地市场足够大，可以根据保险状况进行细分，那么这种溢出效益的规模就会减小。
