Econ Papers Daily / 期刊论文
迈向医疗保健的结构性转型
Structural transformation towards healthcare
摘要
This paper studies variation in healthcare expenditures across time and space using a model of structural transformation tailored to the healthcare sector. It addresses a key tension: cross-country and time-series data show the health spending share rising with overall consumption, suggesting an aggregate income elasticity above one, yet within countries health spending is flat across household incomes, and quasi-experimental spending responses to oil-driven income shocks rise less than one-for-one with income. The calibrated model reconciles this tension in two ways: First, health spending is equalized across incomes by the government or insurers. Second, with an own-price elasticity greater than one in absolute value, positive shocks outside healthcare such as oil income shocks generate price effects that drive the health share down. I find that rising incomes are indeed the dominant driver of healthcare spending, and that reforms that raise the productivity of the healthcare sector will drive its spending share up.
中文摘要
本文运用一个针对医疗部门定制的结构转型模型，研究医疗支出在时间和空间上的变化。文章解决了一个关键矛盾：跨国数据和时间序列数据显示，医疗支出份额随整体消费上升，表明总体收入弹性大于一；然而在一国之内，医疗支出在不同家庭收入间基本持平，且对石油驱动的收入冲击的准实验支出反应低于收入的一对一增长。校准模型通过两种方式调和了这一矛盾：第一，政府或保险公司在不同收入间均等化医疗支出。第二，在自身价格弹性绝对值大于一时，医疗部门之外的正向冲击（如石油收入冲击）会产生价格效应，从而压低医疗支出份额。我发现收入增长确实是医疗支出的主导驱动因素，而提高医疗部门生产率的改革将推动其支出份额上升。