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期刊Journal of Public Economics 2025年(下)保險(xiǎn)精選文章目錄與摘要|保險(xiǎn)學(xué)術(shù)前沿

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期刊介紹:

《Journal of Public Economics》(公共經(jīng)濟(jì)學(xué)雜志)是一本專(zhuān)注于公共經(jīng)濟(jì)學(xué)領(lǐng)域的學(xué)術(shù)期刊。該期刊自1972年成立以來(lái),涉及的主題包括稅收政策、公共支出、社會(huì)保障、公共選擇理論、環(huán)境經(jīng)濟(jì)學(xué)、勞動(dòng)經(jīng)濟(jì)學(xué)、教育經(jīng)濟(jì)學(xué)、衛(wèi)生經(jīng)濟(jì)學(xué)、城市經(jīng)濟(jì)學(xué)和發(fā)展經(jīng)濟(jì)學(xué)等。它探討了公共政策的效率和分配問(wèn)題,以及需求者、供應(yīng)者和其他衛(wèi)生保健機(jī)構(gòu)的行為模型。該刊每年發(fā)行12期,平均每期發(fā)表10篇左右,2024年影響因子為3.5。

本期看點(diǎn):

●失業(yè)保險(xiǎn)可以通過(guò)跨網(wǎng)絡(luò)的風(fēng)險(xiǎn)共擔(dān)來(lái)提高福利,而不會(huì)減少網(wǎng)絡(luò)內(nèi)部通過(guò)非正規(guī)保險(xiǎn)進(jìn)行的風(fēng)險(xiǎn)共擔(dān)。

●雇主提供的醫(yī)療保險(xiǎn)通常包含受撫養(yǎng)人(如子女)的覆蓋條款。延長(zhǎng)受撫養(yǎng)人醫(yī)保資格期限,既提高了受撫養(yǎng)人的參保率,也增強(qiáng)了父母的工作穩(wěn)定性。

●現(xiàn)金轉(zhuǎn)移支付項(xiàng)目有望緩解發(fā)達(dá)國(guó)家的"收入-健康陷阱",保障性收入的增加提升健康水平。

●患病成年人愿意為降低死亡風(fēng)險(xiǎn)支付的每質(zhì)量調(diào)整生命年(QALY)價(jià)值幾乎是健康成年人的兩倍,且降低重病風(fēng)險(xiǎn)與降低輕病風(fēng)險(xiǎn)的價(jià)值相近。

●生前給予繼承人的饋贈(zèng)規(guī)??捎^,且對(duì)稅收政策高度敏感。實(shí)施稅收優(yōu)惠的饋贈(zèng)政策意味著,實(shí)現(xiàn)遺產(chǎn)稅收最大化的統(tǒng)一稅率上限為37%。

●基于韓國(guó)數(shù)據(jù),養(yǎng)老金發(fā)放當(dāng)周的死亡率下降1.2%至1.4%。與月度發(fā)放相比,金額較小但發(fā)放頻率更高的養(yǎng)老金支付模式可能帶來(lái)更強(qiáng)的死亡率降低效應(yīng)。

●營(yíng)銷(xiāo)支付導(dǎo)致醫(yī)生開(kāi)始治療預(yù)測(cè)死亡率較低的癌癥患者。盡管支付導(dǎo)致抗癌藥物支出增加,但患者死亡率并未出現(xiàn)相應(yīng)改善。

※ 本期目錄

●擠出群眾支持?正規(guī)與非正規(guī)保險(xiǎn)之間的替代關(guān)系

●受撫養(yǎng)人醫(yī)療保險(xiǎn)覆蓋與父母的工作鎖定效應(yīng):基于《平價(jià)醫(yī)療法案》的證據(jù)

●現(xiàn)金轉(zhuǎn)移支付對(duì)健康的影響:基于芬蘭基本收入實(shí)驗(yàn)的證據(jù)

●健康風(fēng)險(xiǎn)與生命價(jià)值

●財(cái)富、饋贈(zèng)與臨終遺產(chǎn)規(guī)劃

●養(yǎng)老金收入領(lǐng)取對(duì)短期死亡率與醫(yī)療資源利用的影響:基于韓國(guó)的證據(jù)

●無(wú)功而返:向醫(yī)生推銷(xiāo)抗癌藥物雖增加處方量卻未能降低死亡率

Crowding out crowd support? Substitution between formal and informal insurance

擠出群眾支持?正規(guī)與非正規(guī)保險(xiǎn)之間的替代關(guān)系

作者

Kyle Coombs(瓦薩學(xué)院)

摘要:Interpersonal gifts and loans play an underexplored informal insurance role in high-income countries, posing challenges for social insurance policy design. I examine informal support via person-to-person (P2P) payment platforms using a survey-linked administrative bank transaction dataset covering low-income US users with job loss. Event study estimates show average monthly P2P inflows increase by 1.1 % of lost income one month after job loss before returning to baseline over 10 months. Single mothers receive the largest increases, as do those with high prior earnings or those living in high-income areas. Exploiting three plausibly exogenous changes to federal pandemic UI policy, I estimate that an additional dollar of UI benefits crowds out at most $0.05 of informal transfers. These results imply that UI can raise welfare by pooling risk across networks without reducing within-network risk pooling through informal insurance.

人際饋贈(zèng)與借貸在高收入國(guó)家中扮演著尚未被充分研究的非正規(guī)保險(xiǎn)角色,這給社會(huì)保險(xiǎn)政策設(shè)計(jì)帶來(lái)了挑戰(zhàn)。本文利用一項(xiàng)關(guān)聯(lián)調(diào)查的銀行交易行政數(shù)據(jù)集,研究了通過(guò)個(gè)人對(duì)個(gè)人(P2P)支付平臺(tái)提供的非正規(guī)支持,該數(shù)據(jù)集覆蓋了經(jīng)歷失業(yè)的美國(guó)低收入用戶(hù)。事件研究估計(jì)表明,失業(yè)一個(gè)月后,平均每月P2P流入資金增加至收入損失的1.1%,隨后在10個(gè)月內(nèi)逐漸回歸基線水平。單身母親、先前收入較高者或居住在高收入地區(qū)的人獲得的資金增幅最大。通過(guò)利用聯(lián)邦疫情期間失業(yè)保險(xiǎn)政策的三項(xiàng)看似外生的變化,估計(jì)每增加1美元的失業(yè)保險(xiǎn)福利,最多擠出0.05美元的非正規(guī)轉(zhuǎn)移支付。這些結(jié)果表明,失業(yè)保險(xiǎn)可以通過(guò)跨網(wǎng)絡(luò)的風(fēng)險(xiǎn)共擔(dān)來(lái)提高福利,而不會(huì)減少網(wǎng)絡(luò)內(nèi)部通過(guò)非正規(guī)保險(xiǎn)進(jìn)行的風(fēng)險(xiǎn)共擔(dān)。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S0047272725001975

Dependent insurance coverage and parental job lock: Evidence from the Affordable Care Act

受撫養(yǎng)人醫(yī)療保險(xiǎn)覆蓋與父母的工作鎖定效應(yīng):基于《平價(jià)醫(yī)療法案》的證據(jù)

作者

Hannah Bae(斯坦福大學(xué)),Katherine Meckel(加利福尼亞大學(xué)),Maggie Shi(芝加哥大學(xué))

摘要:Coverage for dependents is a standard feature of employer-sponsored insurance. While prior work shows that employees trade off job mobility for their own coverage, less is known about the intra-family spillovers of dependent coverage on parental labor supply. We study this question using a large panel of employer-based insurance claims that links dependent enrollment to a proxy for parental job retention. We use a regression discontinuity design that exploits a sharp change in the duration of dependent eligibility by birth month under the Affordable Care Act. We find that additional dependent insurance eligibility increases both dependent take-up and parental job retention. This “job lock” effect is strongest among parents more likely to be on the margin of a job exit, for families that place higher value on dependent coverage, and employees of firms offering a broader range of insurance options.

雇主提供的醫(yī)療保險(xiǎn)通常包含受撫養(yǎng)人(如子女)的覆蓋條款。雖然已有研究表明,員工可能為維持自身醫(yī)保而犧牲職業(yè)流動(dòng)性,但受撫養(yǎng)人醫(yī)保覆蓋對(duì)父母勞動(dòng)供給產(chǎn)生的家庭內(nèi)部溢出效應(yīng),學(xué)界卻知之甚少。本研究利用一個(gè)大型雇主醫(yī)保理賠面板數(shù)據(jù)集,將受撫養(yǎng)人的參保情況與父母工作留任的代理指標(biāo)相關(guān)聯(lián),對(duì)這一問(wèn)題展開(kāi)探討。我們采用斷點(diǎn)回歸設(shè)計(jì),基于《平價(jià)醫(yī)療法案》中依據(jù)出生月份導(dǎo)致的受撫養(yǎng)人資格期限突變進(jìn)行分析。研究發(fā)現(xiàn),延長(zhǎng)受撫養(yǎng)人醫(yī)保資格期限,既提高了受撫養(yǎng)人的參保率,也增強(qiáng)了父母的工作穩(wěn)定性。這種"職業(yè)鎖定"效應(yīng)在以下群體中尤為明顯:更可能處于離職邊緣的父母、對(duì)受撫養(yǎng)人醫(yī)保覆蓋估值更高的家庭,以及所在企業(yè)提供更廣泛保險(xiǎn)選擇的員工。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S0047272725001379

Health effects of cash transfers: Evidence from the Finnish basic income experiment

現(xiàn)金轉(zhuǎn)移支付對(duì)健康的影響:基于芬蘭基本收入實(shí)驗(yàn)的證據(jù)

作者

Kari H?m?l?inen(VATT經(jīng)濟(jì)研究所),Miska Simanainen(芬蘭社會(huì)保險(xiǎn)研究所),Jouko Verho(斯德哥爾摩大學(xué))

摘要:This study provides causal evidence that cash transfer programs have the potential to alleviate the income–health trap in advanced countries. We analyze the Finnish basic income experiment, which replaced the minimum unemployment benefits with a guaranteed income for 2,000 randomly selected unemployed persons during the years 2017–2018. The guaranteed income removed all job–search requirements, but participants could still choose to claim unemployment benefits and comply with related obligations. The experiment also increased average income by 9%–11%, for two reasons: basic income payments overlapped with benefits due from the pre-experiment period, and basic income was not tapered against labor earnings. Using register data on all prescription medications and secondary care visits, we find that the experiment reduced psychotropic drug use by 8%–11%. Our results also suggest a decline in outpatient mental health visits for secondary care. No effects were detected for other health outcomes. Since most participants opted out of the unconditionality aspect of the experiment and continued to claim unemployment benefits, we attribute the observed health effects primarily to the increased income.

本研究提供了因果證據(jù),表明現(xiàn)金轉(zhuǎn)移支付項(xiàng)目有望緩解發(fā)達(dá)國(guó)家的"收入-健康陷阱"。我們分析了芬蘭的基本收入實(shí)驗(yàn)——該實(shí)驗(yàn)在2017至2018年間,將2000名隨機(jī)選取的失業(yè)者的最低失業(yè)福利替換為保障性收入。保障性收入取消了所有求職要求,但參與者仍可選擇申領(lǐng)失業(yè)福利并履行相關(guān)義務(wù)。實(shí)驗(yàn)還使平均收入提高了9%-11%,原因有二:基本收入支付與實(shí)驗(yàn)前階段的應(yīng)得福利存在重疊,且基本收入不隨勞動(dòng)收入增加而遞減。通過(guò)使用包含所有處方藥和二級(jí)醫(yī)療就診記錄的登記數(shù)據(jù),我們發(fā)現(xiàn)實(shí)驗(yàn)使精神類(lèi)藥物使用量降低了8%-11%。結(jié)果還表明二級(jí)醫(yī)療門(mén)診中的心理健康就診有所減少。其他健康指標(biāo)未發(fā)現(xiàn)顯著影響。由于大多數(shù)參與者未選擇實(shí)驗(yàn)的無(wú)條件性條款而繼續(xù)申領(lǐng)失業(yè)福利,我們將觀察到的健康效應(yīng)主要?dú)w因于收入增加。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S0047272725001781

Health risk and the value of life

健康風(fēng)險(xiǎn)與生命價(jià)值

作者

Daniel Bauer(威斯康星大學(xué)麥迪遜分校),Darius Lakdawalla(南加州大學(xué)),Julian Reif(伊利諾伊大學(xué))

摘要:We extend the conventional life-cycle framework for valuing health and longevity improvements to a stochastic setting with multiple health states and apply it to data on mortality, quality of life, labor earnings, and medical spending for adults with different comorbidities. We find that sick adults are willing to pay nearly twice as much per quality-adjusted life-year (QALY) to reduce mortality risk as healthy adults, and that reducing the risk of serious illness is valued similarly to reducing the risk of mild illness. Our results provide a rational explanation for why people oppose a single threshold value for rationing care and why they invest less in prevention than in treatment.

我們將傳統(tǒng)的用于評(píng)估健康和壽命改善的生命周期框架擴(kuò)展至包含多重健康狀態(tài)的隨機(jī)情境,并將其應(yīng)用于具有不同合并癥的成年人在死亡率、生活質(zhì)量、勞動(dòng)收入及醫(yī)療支出方面的數(shù)據(jù)。研究發(fā)現(xiàn),患病成年人愿意為降低死亡風(fēng)險(xiǎn)支付的每質(zhì)量調(diào)整生命年(QALY)價(jià)值幾乎是健康成年人的兩倍,且降低重病風(fēng)險(xiǎn)與降低輕病風(fēng)險(xiǎn)的價(jià)值相近。這一結(jié)果從理性角度解釋了為何人們反對(duì)采用單一閾值進(jìn)行醫(yī)療資源分配,以及為何在預(yù)防方面的投入低于治療投入。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S0047272725000441

Wealth, gifts, and estate planning at the end of life

財(cái)富、饋贈(zèng)與臨終遺產(chǎn)規(guī)劃

作者

David Sturrock(倫敦大學(xué)學(xué)院),Stefan Groot(荷蘭合作銀行),Jan M?hlmann(荷蘭經(jīng)濟(jì)政策分析局)

摘要:We show that gifts made to heirs before death are substantial and highly responsive to taxation. Using intergenerationally-linked administrative data from the Netherlands and exploiting variation in the timing of death, we find that single people (including widows) with children transfer around 10 % of their wealth to their children in anticipation of death. This is almost entirely in the form of tax-exempt gifts. Exploiting bunching at kink points in the gift tax schedule and a reform to inheritance taxation, we estimate elasticities of gifts and wealth to taxation and find that tax-avoidance accounts for at least a significant minority of this deathbed giving. The ability to make tax-favoured gifts means that the revenue-maximising flat inheritance tax rate is at most 37 %. Equalising the tax rate on deathbed gifts and inheritances at death would increase revenues raised from singles by 10 %.

我們的研究表明,生前給予繼承人的饋贈(zèng)規(guī)模可觀,且對(duì)稅收政策高度敏感?;诤商m跨代關(guān)聯(lián)的行政數(shù)據(jù),并利用死亡時(shí)間的自然變動(dòng)進(jìn)行分析,我們發(fā)現(xiàn)擁有子女的單身人士(包括喪偶者)在預(yù)期死亡前會(huì)向子女轉(zhuǎn)移約10%的財(cái)富,且?guī)缀跞恳悦舛愷佡?zèng)形式進(jìn)行。通過(guò)利用贈(zèng)與稅制中的稅率拐點(diǎn)聚集現(xiàn)象及一項(xiàng)遺產(chǎn)稅改革政策,我們估算了饋贈(zèng)與財(cái)富對(duì)稅收的彈性,發(fā)現(xiàn)避稅動(dòng)機(jī)至少是此類(lèi)臨終饋贈(zèng)行為的重要成因之一。實(shí)施稅收優(yōu)惠的饋贈(zèng)政策意味著,實(shí)現(xiàn)遺產(chǎn)稅收最大化的統(tǒng)一稅率上限為37%。若將臨終饋贈(zèng)與死亡時(shí)繼承的稅率統(tǒng)一,單身人士群體的相關(guān)稅收收入可增加10%。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S0047272725001902

Short-term mortality and healthcare utilization consequences of pension income receipt: Evidence from South Korea

養(yǎng)老金收入領(lǐng)取對(duì)短期死亡率與醫(yī)療資源利用的影響:基于韓國(guó)的證據(jù)

作者

Mimi Jeon(韓國(guó)公平交易委員會(huì)經(jīng)濟(jì)分析局),Seonghoon Kim(新加坡管理大學(xué)),Kanghyock Koh(高麗大學(xué))

摘要:We examine short-term consequences of pension income receipt on mortality and healthcare utilization within the monthly payment cycle. Using the national death registry data of South Korea, we document that the mortality rate decreases by 1.2–1.4 percent in the week of the disbursement date. The mortality-reducing effects are larger for causes of death that could have been avoided through timely and effective healthcare interventions. Using healthcare claims data, we document that the number of hospital admissions increases during the disbursement week. We provide suggestive evidence of greater mortality-reducing effects from a smaller but more frequent disbursement than from a monthly disbursement.

我們考察了在月度養(yǎng)老金發(fā)放周期內(nèi),收入領(lǐng)取對(duì)死亡率和醫(yī)療資源利用的短期影響。基于韓國(guó)的全國(guó)死亡登記數(shù)據(jù),我們發(fā)現(xiàn)養(yǎng)老金發(fā)放當(dāng)周的死亡率下降1.2%至1.4%。對(duì)于那些通過(guò)及時(shí)有效的醫(yī)療干預(yù)可避免的死亡原因,死亡率降低的效應(yīng)更為明顯。通過(guò)分析醫(yī)療報(bào)銷(xiāo)數(shù)據(jù),我們發(fā)現(xiàn)發(fā)放當(dāng)周的住院人數(shù)有所增加。初步證據(jù)表明,與月度發(fā)放相比,金額較小但發(fā)放頻率更高的養(yǎng)老金支付模式可能帶來(lái)更強(qiáng)的死亡率降低效應(yīng)。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S0047272725001884

Nothing for something: Marketing cancer drugs to physicians increases prescribing without improving mortality

無(wú)功而返:向醫(yī)生推銷(xiāo)抗癌藥物雖增加處方量卻未能降低死亡率

作者

Colleen Carey(美國(guó)國(guó)家經(jīng)濟(jì)研究局),Michael Daly(康奈爾大學(xué))a,Jing Li(華盛頓大學(xué))

摘要:Physicians commonly receive marketing-related transfers from drug firms. We examine the impact of these relationships on the prescribing of physician-administered cancer drugs in Medicare. We find that prescribing of the associated drug increases 4% in the twelve months after a payment is received, with the increase beginning sharply in the month of payment and fading out within a year. A marketing payment also leads physicians to begin treating cancer patients with lower predicted mortality. While payments result in greater expenditure on cancer drugs, there are no associated improvements in patient mortality.

醫(yī)生通常接受來(lái)自制藥公司的營(yíng)銷(xiāo)相關(guān)款項(xiàng)。我們研究了這種關(guān)系對(duì)聯(lián)邦醫(yī)療保險(xiǎn)(Medicare)中醫(yī)生處方開(kāi)立自費(fèi)抗癌藥物的影響。研究發(fā)現(xiàn),在收到款項(xiàng)后的12個(gè)月內(nèi),相關(guān)藥物的處方量增加4%,這一增長(zhǎng)從支付當(dāng)月開(kāi)始顯著上升,并在一年內(nèi)逐漸消退。營(yíng)銷(xiāo)支付還導(dǎo)致醫(yī)生開(kāi)始治療預(yù)測(cè)死亡率較低的癌癥患者。盡管支付導(dǎo)致抗癌藥物支出增加,但患者死亡率并未出現(xiàn)相應(yīng)改善。

原文鏈接:https://www.sciencedirect.com/science/article/pii/S004727272500009X

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