Insurance effects on US medical spending (1960-1993)
回归分析发现,1960-1993年美国人均实际医疗支出增长近一半、1983-1993年增长近三分之二源于保险覆盖水平提高;其余增长主要由保险覆盖引发的商业研发和非商业医学研究推动的技术进步导致。
Regression results show that nearly half of 1960-1993 growth in real per capita medical spending and almost two-thirds of its 1983-1993 growth were due to ever-increasing levels of insurance coverage (the spending portion paid by third parties). Growth in coverage may have played a minor part as well; we would not rule out the standard finding that it has had a positive but relatively small effect. Viewed from a different perspective, the results imply that about two-thirds of 1960-1993 spending growth came via cost-increasing advances in medical technology resulting from: (1) commercial research and development induced by coverage levels and (2) noncommercial medical research. The remaining one-third, was due to standard factors: age-sex mix changes, income growth and coverage growth (the latter playing a small but indeterminate part).