医疗保险优势对受益人和政治的影响:重新审视委托福利国家
Andrea Louise Campbell1, Kimberly J Morgan2
1Massachusetts Institute of Technology.
Journal of health politics, policy and law
|February 28, 2025
概括
与传统医疗保险相比,Medicare Advantage (MA) 计划在受益人体验上没有显著差异. 然而,由于过度支付,MA对政府来说更为昂贵,政治因素阻止了改革.
科学领域:
- 卫生政策 卫生政策
- 公共管理 公共管理
- 政治科学 政治科学是指政治学.
背景情况:
- 2003年的医疗保险改革显著增加了私人管理护理计划在提供医疗保险福利方面的作用.
- 委托福利国家框架 (摩根和坎贝尔,2011) 提供了一个透镜来分析这种转变.
- 了解受益者经验和政治动态对于评估改革成功至关重要.
研究的目的:
- 审查奖学金受益人的经验 (访问,成本,结果) 与医疗保险优势 (MA) 和传统的医疗保险.
- 评估委托治理改革带来的政治反效应.
- 评估有关消费者行为和政策根深蒂固的预测是否已经实现.
主要方法:
- 关于受益人经验和政治反的研究的文献综述.
- 对医疗保险优势和传统医疗保险之间的比较数据的分析.
- 审查政策反机制,包括游说和受益人支持.
主要成果:
- 在MA和传统医疗保险之间,受益体验和满意度水平是可比的.
- 通过管理护理技术,MA计划已经减少了每个受益人的支出.
- 由于供应商的过度支付,MA对联邦政府来说更为昂贵.
结论:
- 政策反效应,包括强大的游说团体和受益人支持,已经阻止了MA过度支付的纠正.
- 政府不愿破坏MA市场,因为它依赖于老年人,阻碍了改革工作.
- 尽管在某些领域节省了成本,但MA对联邦政府的整体财务负担仍然存在.
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