Hitting a moving target: income-related health insurance subsidies for the uninsured.
Hitting a moving target: income-related health insurance subsidies for the uninsured.
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实现不断变化的目标：为未参保者提供与收入相关的健康保险补贴。
DOI：
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发表时间：
2000
影响因子：
3.8
通讯作者：
Pamela Farley Short
中科院分区：
文献类型：
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作者：
Pamela Farley Short
新的政府医疗保险计划可能会强调在市场环境下的自愿购买，补贴针对低收入人群，并强调管理式医疗。这些计划最好有一个保证的入学期，长达六个月至一年。然而，鉴于收入随时间变化，在这么长时间内发放与收入有关的补贴会出现错误。这些误差是在模拟进行评估与纵向数据从收入和方案参与调查。两个分配的补贴，根据目前的收入在入学期间开始时，并在年底评估的实际收入，比较各种方案的设计。对补贴的预期确定有些偏向于多付。净多付额占补贴费用的5%至10%。然而，预期付款鼓励参与补贴计划。在未来补贴的情况下，真实杀伤力的模拟参与率高达73%，而在回顾性和解的情况下，这一比例为69%。通过降低测试收入的频率和延长测试时间，净多付额略有减少。
New government health insurance programs are likely to emphasize voluntary purchases in a market setting, with subsidies targeted at low-income populations and stress on managed care. Such programs are best structured with a guaranteed enrollment period that is as long as six months to a year. However, given that incomes change over time, errors will be made in awarding income-related subsidies for that long. These errors are assessed in simulations undertaken with longitudinal data from the Survey of Income and Program Participation. Two allocations of the subsidies, based on current income at the beginning of the enrollment period and on actual income assessed at the end, are compared for a variety of program designs. Prospective determination of subsidies is somewhat biased toward overpayment. Net overpayments amount to 5-10 percent of subsidy costs. However, prospective payment encourages participation in the subsidy program. The simulated participation rate for true eligibles is as high as 73 percent with prospective subsidies, compared to 69 percent with retrospective reconciliation. Net overpayments are slightly reduced by testing income less frequently and over longer periods.