Implications of Uncollectibles for Hospitalization Coinsurance Rates
研究了医院坏账如何影响团体健康保险的最优共保率，发现医院与支付方协商价格优惠时，风险中性的消费者可能购买精算公平保险，甚至完全保险。
The aim of this article is to study the effects of hospital care uncollectibles on optimal coinsurance rates for group health plans. A model isolates the influence of uncollectibles from the influence of risk aversion. It is found that if hospitals are willing to negotiate price concessions with payer groups, in return for lower patient-copayment responsibilities, a representative risk neutral consumer may purchase actuarially fair insurance. In addition, because the benefits from lower bad debts and any risk pooling may outweigh the costs of moral hazard, the optimal insurance contract may specify full insurance. The theory helps to explain price concessions negotiated by numerous payer groups, such as health maintenance and preferred provider organizations, the contractual allowances given to insurers such as Blue Cross, the attraction of complete prepayment, and non-random health care coverage.