不确定性的影子价格:不可预测的保险覆盖对获得,护理和金融安全的后果
Mark Schlesinger1, Deepon Bhaumik2
1Yale University.
The Milbank quarterly
|April 28, 2025
概括
覆盖的不确定性,或不知道保险覆盖什么,现在阻碍了美国医疗保健的获取,而不是没有保险. 需要进行结构性改革,以帮助家庭应对被保险拒绝的情况,并改善获得护理的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 消费者健康 消费者健康
背景情况:
- 美国的医疗保险改革旨在扩大招生人数并减少财务不安全.
- 复杂的保险条款给消费者在预测需求和做出明智选择方面带来了挑战.
- 覆盖不确定性对保险人员的影响仍未得到充分研究.
研究的目的:
- 评估覆盖率不确定性对医疗保健获取和财务福祉的普遍性和影响.
- 检查随着时间的推移覆盖不确定性的趋势.
- 确定可以缓解覆盖率不确定性的政策策略.
主要方法:
- 使用了多波调查,采用了2009年,2014年和2021年的全国代表性数据.
- 评估了消费者对保险可靠性的担忧以及对保险缺口的经验.
- 估计回归将覆盖不确定性指标与延迟护理,慢性病管理和医疗费用焦虑联系起来.
主要成果:
- 覆盖的不确定性影响了五分之一的美国家庭,是2021年未保险者的五倍.
- 担心覆盖的可靠性和实际覆盖缺口的担忧跟随了U形趋势,在2010年代中期后增加.
- 覆盖的不确定性对及时获得护理,慢性病管理和对医疗费用的焦虑有重大影响.
结论:
- 覆盖的不确定性已经成为美国及时获得医疗保健的主要障碍.
- 现有的流行改革策略可能无意中加剧覆盖率的不确定性.
- 加强对面临被拒绝覆盖的家庭的支持的结构性改革对减轻这些伤害最有希望.
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