Baicker Katherine, Dow William H, Wolfson Jonathan
Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA.
Health Aff (Millwood). 2007 Sep-Oct;26(5):1328-32. doi: 10.1377/hlthaff.26.5.1328.
Consumer-directed health care is a potentially promising tool for moving toward more efficient use of health care resources. Tax policy has long been biased against health plans with significant patient cost sharing. Tax advantages created by health savings accounts (HSAs) began to change that, and proposed tax reforms could go even further. We assess various critiques of these plans, focusing on why they benefit not just the healthy and wealthy. Lower costs and more efficient health spending would help all patients and reduce uninsurance. Potential negative distributional effects are important but can be remedied more efficiently without distorting insurance design.
消费者导向型医疗保健是迈向更高效利用医疗资源的一个潜在的有前景的工具。长期以来，税收政策一直不利于那些患者需承担大量费用的医保计划。健康储蓄账户（HSAs）带来的税收优惠开始改变这种状况，并且拟议中的税收改革可能会走得更远。我们评估了对这些计划的各种批评意见，重点关注它们为何不仅使健康且富有的人受益。降低成本和提高医疗支出效率将有助于所有患者，并减少未参保情况。潜在的负面分配效应很重要，但可以在不扭曲保险设计的情况下更有效地加以补救。
