Monheit A C, Nichols L M, Selden T M
Center for Health Expenditures and Insurance Studies, Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
Inquiry. 1995;32(4):379-91.
The recent health care reform debate has questioned whether the health insurance market effectively pools risks and transfers income across states of health. We use data from the 1987 National Medical Expenditure Survey to examine how net health insurance benefits are distributed in the employment-related insurance market. We find this market to transfer income from those in good health to those with health problems and the tax subsidy from employer health insurance contributions to be a crucial determinant of the net benefit distribution. To the extent society views these transfers as meritorious, our findings suggest caution regarding initiatives to limit or eliminate the tax subsidy.
近期的医疗保健改革辩论对医疗保险市场是否能有效汇聚风险并在不同健康状况之间转移收入提出了质疑。我们使用1987年全国医疗支出调查的数据来研究与就业相关的保险市场中净医疗保险福利是如何分配的。我们发现这个市场会将收入从健康状况良好的人转移到有健康问题的人手中，并且雇主缴纳医疗保险的税收补贴是净福利分配的一个关键决定因素。就社会认为这些转移是有益的程度而言，我们的研究结果表明，对于限制或取消税收补贴的举措应持谨慎态度。
