Department of Economics, Bowling Green State University, Bowling Green, OH, 43403, USA.
Int J Health Econ Manag. 2020 Sep;20(3):251-276. doi: 10.1007/s10754-020-09280-4. Epub 2020 Mar 6.
Uninsured individuals receive fewer healthcare services for at least three reasons: responsibility for the entire bill, higher prices, and potential provider reductions for concern of nonpayment. I isolate reductions when uninsured patients are solely financially responsible by capitalizing on Maryland's highly regulated health care system. Prices are set by the state, are uniform across all patients, and hospitals are compensated for free care and bad debt. I use a unique feature of the data, multiple readmissions for patients who gain or lose insurance between visits, to isolate the reductions in quantity demanded when individuals are faced with paying the full price without an insurance contribution. A Blinder-Oaxaca decomposition estimates uninsured individuals receive 6% fewer services after accounting for differences in patient, illness, and hospital characteristics than when these same individuals are insured.
未参保者接受的医疗服务较少，至少有三个原因：需要承担全部费用、更高的价格，以及医疗机构出于担心欠费而减少服务提供。我通过利用马里兰州高度监管的医疗保健系统，专门研究了在未参保者完全自负费用的情况下服务减少的情况。价格由州政府设定，对所有患者都是统一的，医院会获得免费医疗和坏账补偿。我利用数据的一个独特特征，即对在就诊期间获得或失去保险的患者进行多次再入院治疗，以隔离在个人需要支付全额费用而没有保险支付的情况下，需求数量的减少。通过对患者、疾病和医院特征的差异进行调整，使用 Blinder-Oaxaca 分解法估计，与有保险的个体相比，未参保个体接受的服务减少了 6%。
