{"title":"更高的免赔额会减缓医疗支出的增长吗?","authors":"Molly Frean, M. Pauly","doi":"10.1080/13571516.2022.2135883","DOIUrl":null,"url":null,"abstract":"Abstract High health care spending growth is regarded in all countries as a potential policy problem. The potential for patient cost-sharing to reduce spending levels has been studied extensively; however, there has been very little work on how cost-sharing may also influence spending growth. In this paper, we relate deductibles as a measure of cost-sharing to health care spending growth at the market level. We analyze a novel combination of US state-level panel datasets from 2002 to 2012 and find that higher deductible levels in private group insurance are associated with significantly lower spending growth, particularly for pharmaceuticals. We observe similar results in both OLS and instrumental variables models, where we use measures of employer and worker preferences as instruments for deductible levels. We theorize and conclude that cost-sharing affects spending growth by constraining the use of more costly new technology, a major driver of health care spending growth worldwide.","PeriodicalId":45470,"journal":{"name":"International Journal of the Economics of Business","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Do Higher Deductibles Slow Health Spending Growth?\",\"authors\":\"Molly Frean, M. Pauly\",\"doi\":\"10.1080/13571516.2022.2135883\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract High health care spending growth is regarded in all countries as a potential policy problem. The potential for patient cost-sharing to reduce spending levels has been studied extensively; however, there has been very little work on how cost-sharing may also influence spending growth. In this paper, we relate deductibles as a measure of cost-sharing to health care spending growth at the market level. We analyze a novel combination of US state-level panel datasets from 2002 to 2012 and find that higher deductible levels in private group insurance are associated with significantly lower spending growth, particularly for pharmaceuticals. We observe similar results in both OLS and instrumental variables models, where we use measures of employer and worker preferences as instruments for deductible levels. We theorize and conclude that cost-sharing affects spending growth by constraining the use of more costly new technology, a major driver of health care spending growth worldwide.\",\"PeriodicalId\":45470,\"journal\":{\"name\":\"International Journal of the Economics of Business\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2022-10-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of the Economics of Business\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/13571516.2022.2135883\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"BUSINESS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of the Economics of Business","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/13571516.2022.2135883","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BUSINESS","Score":null,"Total":0}
Do Higher Deductibles Slow Health Spending Growth?
Abstract High health care spending growth is regarded in all countries as a potential policy problem. The potential for patient cost-sharing to reduce spending levels has been studied extensively; however, there has been very little work on how cost-sharing may also influence spending growth. In this paper, we relate deductibles as a measure of cost-sharing to health care spending growth at the market level. We analyze a novel combination of US state-level panel datasets from 2002 to 2012 and find that higher deductible levels in private group insurance are associated with significantly lower spending growth, particularly for pharmaceuticals. We observe similar results in both OLS and instrumental variables models, where we use measures of employer and worker preferences as instruments for deductible levels. We theorize and conclude that cost-sharing affects spending growth by constraining the use of more costly new technology, a major driver of health care spending growth worldwide.
期刊介绍:
International Journal of the Economics of Business presents original, peer reviewed research in economics that is clearly applicable to business or related public policy problems or issues. The term "business" is used in its widest sense to encompass both public and private sector—governmental, private non-profit and cooperative organizations, as well as profit-seeking enterprises. International Journal of the Economics of Business carries papers relating to three main spheres: The organization—to analyse and aid decision making and the internal organization of the business; The industry—to analyse how businesses interact and evolve within and across industries.