Connolly Mark P, Pollard Michael S, Hoorens Stijn, Kaplan Brian R, Oskowitz Selwyn P, Silber Sherman J
Ferring International Center, St Prex, Switzerland.
Am J Manag Care. 2008 Sep;14(9):598-604.
To evaluate whether lifetime future net tax revenues from an in vitro fertilization (IVF)-conceived child are substantial enough to warrant public subsidy relative to the mean IVF treatment costs required to obtain 1 live birth.
Mathematical generational accounting model.
The model estimates direct financial interactions between the IVF-conceived child and the government during the child's projected lifetime. In the model, we accrue IVF costs required to conceive the child to the government, and then we estimate future net tax revenue to the federal and state governments from this individual, offset by direct financial transfers from the government (eg, child allowances, education, Medicare, and Social Security). We discount lifetime costs and gross tax payments at Treasury Department rates to establish the present value of investing in IVF. We applied US Congressional Budget Office projected changes in tax rates over the course of the model.
An IVF-conceived child, average in every respect (eg, future earnings, healthcare consumption, and life expectancy), represents a net positive return to the government. Based on an average employed individual born in 2005, the projected net lifetime tax contribution is US $606,200. Taking into consideration IVF costs and all direct financial interactions, the net present value is US $155,870.
Lifetime net taxes paid from a child relative to the child's initial IVF investment represent a 700% net return to the government in discounted US dollars from fully employed individuals. This suggests that removing barriers to IVF would have positive tax benefits for the government, notwithstanding its beneficial effect on overall economic growth.
评估通过体外受精(IVF)受孕出生的孩子一生未来的净税收收入,相对于获得一次活产所需的平均IVF治疗成本而言,是否足够可观,足以保证公共补贴。
数学代际核算模型。
该模型估计IVF受孕出生的孩子在其预计寿命期间与政府之间的直接财务互动。在模型中,我们将受孕所需的IVF成本记在政府头上,然后估计该个体对联邦和州政府未来的净税收收入,再减去政府的直接财政转移(如儿童津贴、教育、医疗保险和社会保障)。我们按照美国财政部的利率对终身成本和总税收支付进行贴现,以确定投资IVF的现值。我们应用了美国国会预算办公室预测的模型期间税率变化。
一个在各方面都处于平均水平(如未来收入、医疗消费和预期寿命)的IVF受孕出生的孩子,对政府而言代表着净正回报。以2005年出生的平均就业个体为例,预计其终身净税收贡献为606,200美元。考虑到IVF成本和所有直接财务互动,净现值为155,870美元。
相对于孩子最初的IVF投资,孩子一生支付的净税收对政府而言,以贴现美元计算,来自充分就业个体的净回报率为700%。这表明,消除IVF障碍对政府将有积极的税收效益,尽管其对整体经济增长也有有益影响。