Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-1405, USA.
Health Econ Policy Law. 2010 Oct;5(4):437-57. doi: 10.1017/S1744133109990272. Epub 2009 Oct 30.
Questions about the design of the new US Medicare prescription drug benefit were raised even before its passage, where one of the most heated issues has been the number of plans offered to beneficiaries. Whether beneficiaries believe that there should be extensive or limited choice is still an open question. To study this issue, we analyzed data from the Kaiser Family Foundation/Harvard School of Public Health Survey, which included 718 individuals aged 65 years and above. The survey asked these older adults (i) whether they prefer having dozens of plans or for Medicare to offer a restricted number of plans and (ii) whether they think there are too many, too few or the right amount of plans. Our findings show that the majority of beneficiaries (69%) preferred that Medicare offer a limited number of options while only 29% wanted to see dozens of plans on the market. We also examine the effect of education level, income, political affiliation, race and health status on the desire for more or fewer plans. One surprising finding is that seniors with higher education appear to prefer fewer, not more, plan choices. Overall, our results question the merit of offering so many prescription drugs plan choices to Medicare beneficiaries.
关于新的美国医疗保险处方药福利计划的设计问题在其通过之前就已经提出,其中最激烈的问题之一是向受益人提供的计划数量。受益人是否认为应该有广泛或有限的选择仍然是一个悬而未决的问题。为了研究这个问题,我们分析了 Kaiser 家庭基金会/哈佛公共卫生学院调查的数据,其中包括 718 名 65 岁及以上的老年人。该调查询问了这些老年人:(i) 他们是更喜欢有数十种计划,还是希望医疗保险提供有限数量的计划;(ii) 他们认为计划数量过多、过少还是刚刚好。我们的研究结果表明,大多数受益人(69%)希望医疗保险提供有限的选择,而只有 29%的人希望看到市场上有数十种计划。我们还研究了教育水平、收入、政治派别、种族和健康状况对更多或更少计划需求的影响。一个令人惊讶的发现是,受教育程度较高的老年人似乎更喜欢选择较少的计划,而不是更多的计划。总的来说,我们的研究结果对向医疗保险受益人提供如此多的处方药计划选择的好处提出了质疑。