Deutsche Bundesbank, Germany.
International Institute for Applied Systems Analysis (IIASA), Austria; Wittgenstein Centre (IIASA, OeAW, University of Vienna), Austria.
J Health Econ. 2023 Jan;87:102717. doi: 10.1016/j.jhealeco.2022.102717. Epub 2023 Jan 11.
We study the impact of health insurance expansion on medical spending, longevity and welfare in an OLG economy in which individuals purchase health care to lower mortality and medical progress is profit-driven. Three sectors are considered: final goods production; a health care sector, selling medical services to individuals; and an R&D sector, selling increasingly effective medical technology to the health care sector. We calibrate the model to the development of the US economy/health care system from 1965 to 2005 and study numerically the impact of the insurance expansion. We find that more extensive health insurance accounts for a large share of the rise in US health spending but also boosts the rate of medical progress. A welfare analysis shows that while the subsidization of health care through health insurance creates excessive health care spending, the gains in life expectancy brought about by induced medical progress more than compensate for this.
我们研究了医疗保险扩张对一个 OLG 经济中医疗支出、寿命和福利的影响，在这个经济中，个人购买医疗保健以降低死亡率，而医学进步是由利润驱动的。考虑了三个部门：最终商品生产；医疗保健部门，向个人销售医疗服务；以及研发部门，向医疗保健部门销售越来越有效的医疗技术。我们根据 1965 年至 2005 年美国经济/医疗体系的发展情况对模型进行了校准，并对保险扩张的影响进行了数值研究。我们发现，更广泛的医疗保险占美国医疗支出增长的很大一部分，但也提高了医疗进步的速度。福利分析表明，虽然通过医疗保险补贴医疗保健会导致过度的医疗保健支出，但诱导的医学进步带来的预期寿命的提高足以弥补这一点。
