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1美元重要吗?医疗需求对小额共付费用的反应

Does $1 matter? Health care demand response to a small copayment
Journal of Public Economics · 2026 · Yunji Choi

中文摘要

本文探讨医疗需求如何对低至1美元的共付费用作出反应。医疗福利(MB)是一项面向低收入群体的医疗保险计划。我利用这样一种制度安排:仅对部分此前享受免费医疗的MB参保者引入1美元的共付费用。1美元的价格使每月门诊就诊次数减少了10%。我发现,抗生素的不当使用等低价值医疗服务有所减少,而慢性病患者用药依从性等高价值医疗服务受到的影响可以忽略不计。研究结果表明,小额共付费用有助于缓解潜在的道德风险,同时不会牺牲基本医疗服务的可及性。

Abstract

This paper explores how health care demand responds to a copayment as small as $1. Medical Benefit (MB) is a health insurance plan provided to the low-income group. I exploit a setting where a copayment of $1 was introduced only to a portion of the MB enrollees who previously received free care. The price of $1 reduced monthly outpatient visits by 10 percent. While I find a reduction in low-value care, such as the inappropriate use of antibiotics, I find a negligible effect on high-value care, such as medication adherence for patients with chronic illnesses. The findings suggest that a small copayment can help mitigate potential moral hazard risk while not forgoing access to essential care.
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