Bovbjerg R R, Koller C F
Inquiry. 1986 Summer;23(2):111-21.
State health insurance pools have been suggested to help cover the uninsured. Their attraction lies in the theoretical economies of pooling and the limited public role intended for their administration and funding. Almost all existing pools have targeted high health risks, otherwise uninsurable people who can still afford high premiums for conventional, major-medical-style coverage. Enrollments have been low, even relative to the small eligible population, and medical spending high. Little risk pooling or other savings seem to have occurred. Deficits have therefore mounted, necessitating increased assessments on all private health insurers in pool states and indirectly burdening state treasuries as well. Better pools would have to attract a broader mix of risks, actively manage medical spending, or both.
有人建议设立州健康保险集合计划来帮助覆盖未参保人群。其吸引力在于理论上的集合经济以及计划管理和资金筹集方面有限的公共角色。几乎所有现有的集合计划都针对高健康风险人群，即那些仍能负担传统重大医疗式保险高额保费但原本无法参保的人群。参保人数一直很低，即使相对于规模较小的符合条件人群也是如此，而且医疗支出很高。似乎几乎没有实现风险集合或其他节省。因此，赤字不断增加，这就需要对集合计划州的所有私人健康保险公司提高征费，也间接给州财政造成负担。更好的集合计划必须吸引更广泛的风险组合，积极管理医疗支出，或者两者兼顾。
