Centre for Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia.
NHMRC Chronic Kidney Disease Centre of Research Excellence, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Appl Health Econ Health Policy. 2018 Feb;16(1):31-41. doi: 10.1007/s40258-017-0338-6.
The appropriate structure, scope and cost of government incentives in the private health insurance (PHI) market is a matter of ongoing debate.
In order to inform policy decisions we designed a two-stage study to (1) model the uptake of PHI covering hospital treatment in Australia, and (2) identify the costs of various policy scenarios to the government.
Using a microsimulation with a cost-benefit component, we modelled the insurance decisions made by individuals who collectively represented the Australian insurance population in the financial year 2014-15.
We found that the mean willingness to pay (WTP) for PHI ranged from A$446 to A$1237 per year depending on age and income. Our policy scenarios showed a considerable range of impacts on the government budget (from A$4 billion savings to A$6 billion expense) and PHI uptake (from 3.4 million fewer to 2.5 million more individuals insured), with cost-effectiveness ranging from -A$305 to A$22,624 per additional person insured, relative to the status quo.
Based on the scenario results we recommend policy adjustments that either increase the PHI uptake at a small per-person cost to the public budget or substantially reduce government subsidisation of PHI at a relatively small loss in terms of persons insured.
政府在私人医疗保险（PHI）市场中的激励措施的适当结构、范围和成本是一个持续存在的争议问题。
为了为政策决策提供信息，我们设计了一项两阶段的研究，（1）对澳大利亚覆盖住院治疗的 PHI 的参保情况进行建模，（2）确定各种政策方案对政府的成本。
我们使用具有成本效益组成部分的微观模拟，对在 2014-15 财年代表澳大利亚保险人群的个人的保险决策进行建模。
我们发现，个人对 PHI 的平均意愿支付（WTP）范围为每年 446 澳元至 1237 澳元，具体取决于年龄和收入。我们的政策方案显示对政府预算（从节省 40 亿澳元到增加 60 亿澳元）和 PHI 参保率（从减少 340 万人到增加 250 万人）有相当大的影响，成本效益从每增加一个参保人增加 305 澳元到增加 22624 澳元不等，与现状相比。
基于情景结果，我们建议进行政策调整，要么以对公共预算每人成本增加很小的方式增加 PHI 的参保率，要么以相对较小的参保人数损失大幅减少政府对 PHI 的补贴。
