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基于雇主的医疗保险。

Employer-based health insurance.

作者信息

Wallen J, Williams S R

出版信息

J Health Polit Policy Law. 1982 Summer;7(2):366-79. doi: 10.1215/03616878-7-2-366.

Abstract

Employer-based health insurance (insurance that is purchased by employers for their employees and financed through employer or joint employer-employee contributions) is currently subsidized in part by the federal government through tax exclusions for employer contributions to employee health insurance plans. This subsidization costs the federal government close to 10 billion dollars a year in lost revenues. Many proposed national health insurance plans assign a key role to employer-based health insurance as a vehicle for financing health care. Federal subsidization of employer-based health insurance and plans that assign employers a key role in the administration of a national health insurance plan both assume that private industry acts to realize federal health policy goals-- particularly cost containment--in administering health insurance plans. Little is known, however, about how employers go about selecting the plans they offer their employees or about the incentives and disincentives regarding cost of care than are created by employer-based health insurance. Existing evidence suggests that rather than helping to contain health care costs, employer-based health insurance may be partly responsible for their present escalation. In addition, employer-based health insurance may not be the most equitable way to implement a national health insurance plan.

摘要

基于雇主的医疗保险(即由雇主为其雇员购买并通过雇主或雇主与雇员共同缴费来融资的保险)目前部分由联邦政府补贴,方式是对雇主为雇员医疗保险计划的缴费给予税收减免。这种补贴每年使联邦政府损失近100亿美元的收入。许多提议的国家医疗保险计划赋予基于雇主的医疗保险关键作用,将其作为医疗保健融资的一种手段。联邦政府对基于雇主的医疗保险的补贴以及赋予雇主在国家医疗保险计划管理中关键作用的计划,都假定私营企业在管理医疗保险计划时会采取行动以实现联邦卫生政策目标——特别是成本控制。然而,对于雇主如何选择提供给雇员的保险计划,以及基于雇主的医疗保险所产生的与医疗费用相关的激励和抑制因素,人们知之甚少。现有证据表明,基于雇主的医疗保险非但没有帮助控制医疗费用,反而可能在一定程度上导致了目前医疗费用的上涨。此外,基于雇主的医疗保险可能不是实施国家医疗保险计划最公平的方式。

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