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财富能买到健康吗?一个包含货币性与非货币性健康投资的模型

Can Wealth Buy Health? A Model of Pecuniary and Non-Pecuniary Investments in Health
Journal of the European Economic Association · 2023 · Panos Margaris、Johanna Wallenius

中文摘要

本文构建了一个包含货币性与非货币性健康投资的生命周期模型,以解释美国健康状况与预期寿命的社会经济梯度。个体积累健康资本,健康资本影响劳动生产率、效用、医疗支出冲击的分布以及预期寿命。我们发现,医疗保险覆盖的不平等在形成所观测到的健康与寿命差距方面,作用微乎其微。全民医疗保险增加了预防性医疗支出,却没有增加用于促进健康的活动时间,因为随着医疗保险覆盖的增加,个体不再为如何规避高额治疗性医疗支出冲击而担忧。我们的研究结果表明,终身收入、偏好和健康冲击的差异是预期寿命不平等的主要决定因素。

Abstract

Abstract In this paper, we develop a life cycle model that features pecuniary and non-pecuniary investments in health in order to rationalize the socioeconomic gradients in health and life expectancy in the United States. Agents accumulate health capital, which affects labor productivity, utility, the distribution of medical spending shocks, and life expectancy. We find that unequal health insurance coverage plays a negligible role in generating the observed gaps in health and longevity. Universal health insurance increases preventive medical spending but not time spent in health promoting activities, as individuals are no longer worried about avoiding high curative medical expenditure shocks due to increased health insurance coverage. Our findings suggest that differences in lifetime income, preferences, and health shocks are the main determinants of inequality in life expectancy.
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