貧困層を含む:メディケイドの拡大による財政的影響
K E Thorpe1, J E Siegel, T Dailey
1Department of Health Policy and Management, School of Public Health, Harvard University, Boston, Mass. 02115.
JAMA
|February 17, 1989
まとめ
この研究では,低所得者層の医療保険の拡大を含む,メディケイド改革案の財政的影響を分析しています. 改革は,適格性や給付を改善することを目的としており,推定費用は医療費の節約によって相殺される可能性がある.
科学分野:
- 健康経済学 医療経済学
- 公衆衛生政策 公共衛生政策
- ヘルスケア・ファイナンス・ヘルスケア・ファイナンス
背景:
- アメリカ国民のための保健政策アジェンダは,メディケイドの包括的な改革を提案した.
- 現在のメディケイドプログラムは,異なる資格基準,対象範囲,およびプロバイダの支払い率を持っています.
研究 の 目的:
- 提案されたメディケイド改革の財政的影響を推定する.
- 保険の範囲を拡大し,福利を改善することで生じるコストの影響を分析する.
主な方法:
- 提案された政策変更の財政的影響分析.
- 連邦貧困ライン以下の未保険の非高齢者へのメディケイドの拡大に関連する費用の推定.
- 医療システム内の潜在的なコストオフセットのモデリング.
主要な成果:
- 連邦貧困線以下にあるすべての未保険の非高齢者を対象にメディケイドの拡大は,およそ90億ドルの費用がかかると推定されています.
- これらのコストの重要な部分は,現在の医療費の削減によって相殺される可能性があります.
- 州給付パッケージと提供者給付率の改善は,大幅なコスト増加につながる可能性があります.
結論:
- メディケイド改革は,財政上の大きな考慮事項を提示しています.
- 財政的な影響は,給付強化の範囲と民間保険市場の反応に依存する.
- 改革の詳細を慎重に検討することは,コストを管理し,利益を最大化するために不可欠です.
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