| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w12972 |
| 来源ID | Working Paper 12972 |
| Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly | |
| Amitabh Chandra; Jonathan Gruber; Robin McKnight | |
| 发表日期 | 2007-03-14 |
| 出版年 | 2007 |
| 语种 | 英语 |
| 摘要 | Patient cost-sharing for primary care and prescription drugs is designed to reduce the prevalence of moral hazard in medical utilization. Yet the success of this strategy depends on two factors: the elasticity of demand for those medical goods, and the risk of downstream hospitalizations by reducing access to beneficial health care. Surprisingly, we know little about either of these factors for the elderly, the most intensive consumers of health care in our country. We remedy both of these deficiencies by studying a policy change that raised patient cost-sharing for retired public employees in California. We find that physician office visits and prescription drug utilization are price sensitive, with implied arc-elasticities that are similar to those of the famous RAND Health Insurance Experiment (HIE). However, unlike the HIE, we find substantial "offset" effects in terms of increased hospital utilization in response to the combination of higher copayments for physicians and prescription drugs. These offset effects are concentrated in patients for whom medical care is presumably efficacious: those with a chronic disease. Finally, we find that the savings from increased cost-sharing accrue mostly to the supplemental insurer, while the costs of increased hospitalization accrue mostly to Medicare; thus, there is a fiscal externality associated with cost-sharing increases by supplemental insurers. Our findings suggest that health insurance should be tied to underlying health status, with chronically ill patients facing lower cost-sharing. We also conclude that the externalities to Medicare from supplemental insurance coverage may be more modest than previously suggested due to these offsets. |
| 主题 | Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w12972 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/570638 |
| 推荐引用方式 GB/T 7714 | Amitabh Chandra,Jonathan Gruber,Robin McKnight. Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly. 2007. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w12972.pdf（366KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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