美国医疗保健支出增长模式解析

Understanding Growth Patterns in US Health Care Expenditures

Journal of the European Economic Association · 2018
被引 33
人大 AABS 4

中文导读

研究了1970-2007年OECD国家医疗支出占GDP比重的上升趋势,发现美国是异常值,且其额外增长集中在1978-1990年。通过增长核算,提出医疗相对价格差异而非技术或质量是主因。

Abstract

We study the steady upward trend of Health Care Expenditures (HCE) over GDP for a sample of OECD countries between 1970 and 2007. Although the United States is clearly an outlier, almost all of the additional increase in US HCE happened during the 1978–1990 period. We perform two growth accounting exercises to explore sources of variability of HCE over GDP across countries. In the first growth accounting exercise based on value added we find that factor accumulation is unable to replicate the observed growth patterns. We also show that the additional increase in markups in the US corporate medical sector mimics well the ratio of HCE over GDP in the United States. This suggests that differences in the relative price of health care—rather than technology, product quality, and factor accumulation—could explain the divergent growth patterns of HCE over GDP across these countries. In the second growth accounting exercise, we filter out prices from HCE over GDP, and confirm that there is very little variability for the product quality residual to explain the variation in HCE across countries.

医疗支出增长GDP占比增长核算相对价格