老年居民健康波动、医疗支出风险与医疗保险风险分担
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财经研究 2012 年 第 38 卷第 10 期, 页码：69 - 79
摘要
参考文献
摘要
文章研究了城镇老年居民健康波动对总体、个人自负和统筹支付三个方面医疗支出的影响,并分析了医疗保险统筹基金的风险分担作用。研究发现:(1)健康波动会产生医疗支出风险,这一风险主要由影响健康的持续性因子波动所致;对于参加职工基本医疗保险的居民来说,统筹基金同样面临支付风险。(2)健康波动产生的大病支出风险绝大部分由职工基本医疗保险统筹基金承担,个人自负支出风险则相对较小。具体来说,65岁时发生的健康波动会使0.1%的居民在未来面临不低于50万元的额外医疗支出,其中55%将由统筹基金承担。随着我国人口老龄化,除了落实个人账户外,政府还应进一步充实社会统筹基金和大病基金,以分担大病支出风险,并缓解"看病贵"的问题。
[1]封进,李珍珍.中国农村医疗保障制度的补偿模式研究[J].经济研究,2009,(4):103-115.
[2]罗楚亮.健康风险与贫困人口的消费保险[J].卫生经济研究,2006,(1):36-38.
[3]罗楚亮.健康风险、医疗保障与农村家庭内部资源配置[J].中国人口科学,2007,(2):34-42.
[4]许玲丽,龚关,王红梅.城镇职工基本医疗保险下的医疗支出研究——不可忽视的持续性特征[J].财经研究,2011,(5):25-35.
[5]许玲丽.社会统筹支付在居民终生医疗支出中的分担作用研究——对城镇职工基本医疗保险政策的实证研究[J].世界经济文汇,2011,(2):69-86.
[6]姚仲玲,周子君.大病医疗费用社会统筹调查[J].中华医院管理杂志,1996,(10):608-612.
[7]Anderson G F,Hussey P S.Population aging:A comparison among industrialized countries[J].Health Affairs,2000,19(3):191-203.
[8]Coile C C.Health shocks and couples’labor supply decisions[R].NBER Working Pa-per No.10810,2004.
[9]Feenberg D,Skinner J.The risk and duration of catastrophic health care expenditures[J].Review of Economics and Statistics,1994,76(4):633-647.
[10]French E,Jones J.On the distribution and dynamics of health care costs[J].Journal of Applied Econometrics,2004,19(6):705-721.
[11]Gustavsson M.The1990srise in Swedish earnings inequality—Persistent or transito-ry?[J].Applied Economics,2007,39(1):25-30.
[12]Hoover D R,Crystal S,Kumar R,et al.Medical expenditures during the last year of life:Findings from the1992-1996medicare current beneficiary survey[J].Health Services Research,2002,37(6):1625-1642.
[13]Hubbard R,Skinner J,Zeldes S.Precautionary saving and social insurance[J].Journal of Political Economy,1995,103(2):360-399.
[14]Lindelow M,Wagstaff A.Health shocks in China:Are the poor and uninsured less pro-tected?[R].World Bank Policy Research Working Paper No.3740,2005.
[15]Lubitz J D,Riley G F.Trends in medicare payments in the last year of life[J].New England Journal of Medicine,1993,328(15):1092-1096.
[16]McGarry K,Schoeni R.Medicare gaps and widow poverty[J].Social Security Bulle-tin,2005,66(1):58-74.
[17]McGarry K,Skinner J.Out-of-pocket medical expenses and retirement security[R].Working Paper,2008.
[18]Myck M,Ochmann R,Qari S.Dynamics of earnings and hourly wages in Germany[R].IZA Discussion Papers No.3751,2008.
[19]Smith J P.Healthy bodies and thick wallets:The dual relation between health and eco-nomics status[J].Journal of Economic Perspectives,1999,13(2):145-166.
[20]Smith J P.Consequences and predictors of new health events[A].Wise D A.Analyses in the economics of aging[C].Chicago:University of Chicago Press and NBER,2005.
[21]Yi Y,Maynard A,Liu G,et al.Equity in health care financing:Evaluation of the cur-rent urban employee health insurance reform in China[J].Journal of the Asia Pacific Economy,2005,10(4):506-527.
[22]Zhao Z.Earnings instability and earnings inequality in urban China:1989-2006[R].IZA Discussion Papers No.3270,2007.
[2]罗楚亮.健康风险与贫困人口的消费保险[J].卫生经济研究,2006,(1):36-38.
[3]罗楚亮.健康风险、医疗保障与农村家庭内部资源配置[J].中国人口科学,2007,(2):34-42.
[4]许玲丽,龚关,王红梅.城镇职工基本医疗保险下的医疗支出研究——不可忽视的持续性特征[J].财经研究,2011,(5):25-35.
[5]许玲丽.社会统筹支付在居民终生医疗支出中的分担作用研究——对城镇职工基本医疗保险政策的实证研究[J].世界经济文汇,2011,(2):69-86.
[6]姚仲玲,周子君.大病医疗费用社会统筹调查[J].中华医院管理杂志,1996,(10):608-612.
[7]Anderson G F,Hussey P S.Population aging:A comparison among industrialized countries[J].Health Affairs,2000,19(3):191-203.
[8]Coile C C.Health shocks and couples’labor supply decisions[R].NBER Working Pa-per No.10810,2004.
[9]Feenberg D,Skinner J.The risk and duration of catastrophic health care expenditures[J].Review of Economics and Statistics,1994,76(4):633-647.
[10]French E,Jones J.On the distribution and dynamics of health care costs[J].Journal of Applied Econometrics,2004,19(6):705-721.
[11]Gustavsson M.The1990srise in Swedish earnings inequality—Persistent or transito-ry?[J].Applied Economics,2007,39(1):25-30.
[12]Hoover D R,Crystal S,Kumar R,et al.Medical expenditures during the last year of life:Findings from the1992-1996medicare current beneficiary survey[J].Health Services Research,2002,37(6):1625-1642.
[13]Hubbard R,Skinner J,Zeldes S.Precautionary saving and social insurance[J].Journal of Political Economy,1995,103(2):360-399.
[14]Lindelow M,Wagstaff A.Health shocks in China:Are the poor and uninsured less pro-tected?[R].World Bank Policy Research Working Paper No.3740,2005.
[15]Lubitz J D,Riley G F.Trends in medicare payments in the last year of life[J].New England Journal of Medicine,1993,328(15):1092-1096.
[16]McGarry K,Schoeni R.Medicare gaps and widow poverty[J].Social Security Bulle-tin,2005,66(1):58-74.
[17]McGarry K,Skinner J.Out-of-pocket medical expenses and retirement security[R].Working Paper,2008.
[18]Myck M,Ochmann R,Qari S.Dynamics of earnings and hourly wages in Germany[R].IZA Discussion Papers No.3751,2008.
[19]Smith J P.Healthy bodies and thick wallets:The dual relation between health and eco-nomics status[J].Journal of Economic Perspectives,1999,13(2):145-166.
[20]Smith J P.Consequences and predictors of new health events[A].Wise D A.Analyses in the economics of aging[C].Chicago:University of Chicago Press and NBER,2005.
[21]Yi Y,Maynard A,Liu G,et al.Equity in health care financing:Evaluation of the cur-rent urban employee health insurance reform in China[J].Journal of the Asia Pacific Economy,2005,10(4):506-527.
[22]Zhao Z.Earnings instability and earnings inequality in urban China:1989-2006[R].IZA Discussion Papers No.3270,2007.
引用本文
许玲丽, 龚关, 周亚虹. 老年居民健康波动、医疗支出风险与医疗保险风险分担[J]. 财经研究, 2012, 38(10): 69–79.
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