Stanford University, Stanford, California, and National Bureau of Economic Research, Cambridge, Massachusetts.
Massachusetts Institute of Technology and National Bureau of Economic Research, Cambridge, Massachusetts.
J Econ Perspect. 2013 Winter;27(1):197-222. doi: 10.1257/jep.27.1.197.
We re-present and re-examine the analysis from the famous RAND Health Insurance Experiment from the 1970s on the impact of consumer cost sharing in health insurance on medical spending. We begin by summarizing the experiment and its core findings in a manner that would be standard in the current age. We then examine potential threats to the validity of a causal interpretation of the experimental treatment effects stemming from different study participation and differential reporting of outcomes across treatment arms. Finally, we re-consider the famous RAND estimate that the elasticity of medical spending with respect to its out-of-pocket price is −0.2, emphasizing the challenges associated with summarizing the experimental treatment effects from non-linear health insurance contracts using a single price elasticity.
我们重新呈现和重新检查了 20 世纪 70 年代著名的兰德健康保险实验（RAND Health Insurance Experiment）关于医疗保险中消费者分担成本对医疗支出影响的分析。我们首先以当前时代的标准方式总结实验及其核心发现。然后，我们研究了由于不同的研究参与和治疗组之间不同的结果报告而对实验处理效果的因果解释的有效性造成的潜在威胁。最后，我们重新考虑著名的兰德估计，即医疗支出对自付价格的弹性为-0.2，强调了使用单一价格弹性总结非线性医疗保险合同的实验处理效果所面临的挑战。
