Physicians for a National Health Program, Minnesota Chapter, USA.
J Health Polit Policy Law. 2013 Jun;38(3):479-504. doi: 10.1215/03616878-2079523. Epub 2013 Feb 15.
The Centers for Medicare and Medicaid Services (CMS) annually publishes two measures of Medicare's administrative expenditures. One of these appears in the reports of the Medicare Boards of Trustees and the other in the National Health Expenditure Accounts (NHEA). The latest trustees' report indicates Medicare's administrative expenditures are 1 percent of total Medicare spending, while the latest NHEA indicates the figure is 6 percent. The debate about Medicare's administrative expenditures, which emerged several years ago, reflects widespread confusion about these data. Critics of Medicare argue that the official reports on Medicare's overhead ignore or hide numerous types of administrative spending, such as the cost of collecting taxes and Part B premiums. Defenders of Medicare claim the official statistics are accurate. But participants on both sides of this debate fail to cite the official documents and do not analyze CMS's methodology. This article examines the controversy over the methodology CMS uses to calculate the trustees' and NHEA's measures and the sources of confusion and ignorance about them. It concludes with a discussion of how the two measures should be used.
医疗保险和医疗补助服务中心（CMS）每年公布两项衡量医疗保险行政支出的指标。其中一个出现在医疗保险受托人报告中，另一个出现在国家卫生支出账户（NHEA）中。最新的受托人报告显示，医疗保险的行政支出占医疗保险总支出的 1%，而最新的 NHEA 显示这一数字为 6%。几年前出现的关于医疗保险行政支出的争论反映了人们对这些数据的广泛混淆。医疗保险的批评者认为，官方关于医疗保险间接费用的报告忽视或隐藏了许多类型的行政支出，例如征收税款和 B 部分保费的成本。医疗保险的捍卫者则声称官方统计数据是准确的。但这场争论双方的参与者都没有引用官方文件，也没有分析 CMS 的方法。本文探讨了 CMS 计算受托人报告和 NHEA 指标所使用的方法的争议，以及对这些指标的混淆和无知的根源。最后讨论了如何使用这两个指标。
