Lakdawalla Darius, Yin Wesley
University of Southern California and NBER.
Boston University and NBER.
Rev Econ Stat. 2015 May 1;97(2):314-331. doi: 10.1162/REST_a_00463.
By influencing the size and bargaining power of private insurers, public subsidization of private health insurance may project effects beyond the subsidized population. We test for such spillovers by analyzing how increases in insurer size resulting from the implementation of Medicare Part D affected drug prices negotiated in the non-Medicare commercial market. On average, Part D lowered prices for commercial enrollees by 3.7%. The external commercial market savings amount to $1.5 billion per year, which, if passed to consumers, approximates the internal cost-savings of newly-insured subsidized beneficiaries. If retained by insurers, it corresponds to a 5% average increase in profitability.
通过影响私人保险公司的规模和议价能力，对私人医疗保险的公共补贴可能会产生超出补贴人群的影响。我们通过分析医疗保险D部分的实施导致的保险公司规模增加如何影响非医疗保险商业市场中谈判的药品价格，来测试这种溢出效应。平均而言，D部分使商业参保者的药品价格降低了3.7%。外部商业市场每年节省15亿美元，如果将这笔节省传递给消费者，大致相当于新参保补贴受益人的内部成本节省。如果由保险公司保留，这相当于盈利能力平均提高5%。
