社会医疗保险成本分担制的制度效应——兰德医疗保险实验的启示

Effects of Cost-sharing Arrangements in Social Health Insurance:Lessons from the Rand Health Insurance Experiment

社会医疗保险通常有成本分担的制度安排,然而,长期以来,对于成本分担制的效应存在着争议,争议的核心在于成本分担制减少的医疗服务到底是属于必需的还是非必需的,因此,是否最终对健康产出有负影响。著名的兰德医疗保险实验对上述问题进行了回答。详细综述和分析了该实验的背景、方法、主要结论及其局限性。

Several cost sharing arrangements such as co-payment and coinsurance are often seen in social health insurance, however, for a long time, there existed debates on the effects of cost-sharing arrangements, the core is whether these arrangements could reduce the necessary use of medical care and therefore whether they are harmful in terms of personal health outcomes. A famous experiment-the rand health insurance experiment （RHIE） answered the above questions. This paper reviewed and analyzed the background, experiment methods, main conclusions and some limitations of the RHIE.