Macroeconomic consequences of alternative reforms to the health insurance system in the United States

IF 0.5 4区 经济学 Q4 ECONOMICS International Studies of Economics Pub Date : 2023-09-17 DOI:10.1002/ise3.65
Zhigang Feng
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Abstract

This paper presents a dynamic general equilibrium model designed to examine the macroeconomic effects and welfare implications of alternative reforms to the US health insurance system. Specifically, it scrutinizes the extent to which health care reform can mitigate inefficiencies stemming from market imperfections in the health insurance industry. The model considers a stochastic overlapping generations framework, incorporating heterogeneous agents who are subject to uncertain health shocks. These individuals make optimal decisions regarding labor supply, health insurance, and medical services. Given that the optimal levels of medical consumption and hours worked are endogenous, this setting encapsulates general equilibrium effects. The model is calibrated to US data, and numerical simulations suggest that suitable adjustments to the present health insurance system can broaden coverage and enhance welfare. This improvement is achieved by reducing adverse selection, improving overall health status, and lessening tax distortions on labor supply.

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美国医疗保险制度替代改革的宏观经济后果
本文提出了一个动态一般均衡模型,旨在研究美国医疗保险体系替代改革的宏观经济效应和福利影响。具体而言,该模型研究了医疗改革能在多大程度上缓解医疗保险行业因市场不完善而导致的效率低下问题。该模型考虑了随机世代重叠框架,纳入了受不确定健康冲击影响的异质性代理人。这些个体会就劳动力供给、健康保险和医疗服务做出最优决策。鉴于医疗消费和工作时间的最优水平是内生的,这一设定包含了一般均衡效应。该模型根据美国数据进行了校准,数值模拟结果表明,对现行医疗保险制度进行适当调整,可以扩大覆盖范围,提高福利水平。这种改善是通过减少逆向选择、改善总体健康状况和减少税收对劳动力供给的扭曲来实现的。
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