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A mechanism for privatizing the choice of social insurance.

机译：将社会保险选择私有化的机制。

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摘要

In this dissertation I introduce a mechanism that provides optimal incentives to consumers who choose from multiple types of publicly subsidized health insurance. In the first chapter, I propose a scheme in which consumers choose either a default public insurance product, or from a set of insurance products offered by private insurers. A consumer who opts out of public insurance pays a “fee,” which can be positive or negative. Consumers are randomly assigned to “supervisors.” A supervisor chooses a separate fee for each private insurance product, which is paid by her consumers who choose that particular product. The supervisors are rewarded according to the Relative Taxpayer Surplus (RTS) Mechanism. This mechanism induces the supervisors to set fees in a way that in turn creates the correct incentives for consumers and private producers of insurance. If the supply of health insurance is perfectly competitive, and if consumers, producers, and supervisors have the same information about consumers' health prospects, then insurance is allocated and produced efficiently. In the second chapter I use data from a survey of elderly Americans to quantify the effect of private insurance their public insurance on their health care utilization. I find that this supplemental insurance increases utilization, which likely increases the cost of the public insurance. I then show how the RTS Mechanism can be employed so that supervisors provide the correct incentives to the elderly who purchase supplemental insurance. In the third chapter I adapt the RTS Mechanism such that the supervisors set fees for multiple types of publicly produced health insurance. I conclude by discussing how the privatization scheme can be applied to other types of social insurance.
机译：在本文中，我介绍了一种机制，可为从多种类型的公共补贴医疗保险中选择的消费者提供最佳激励。在第一章中，我提出了一种方案，消费者可以选择默认的公共保险产品，也可以从私人保险公司提供的一组保险产品中进行选择。选择退出公共保险的消费者要支付“费用”，可以是正面的或负面的。消费者被随机分配给“主管”。主管为每种私人保险产品选择单独的费用，由选择该特定产品的消费者支付。主管人员根据相对纳税人盈余（RTS）机制获得奖励。这种机制促使监管者以一定的方式设定费用，从而为消费者和私人保险生产者创造正确的激励机制。如果健康保险的供应具有完全竞争性，并且如果消费者，生产者和管理者对消费者的健康前景具有相同的信息，则可以有效地分配和生产保险。在第二章中，我将使用对美国老年人的调查数据来量化私人保险，公共保险对他们的医疗保健利用的影响。我发现这种补充保险会提高利用率，这很可能会增加公共保险的成本。然后，我将说明如何使用RTS机制，以便主管人员为购买补充保险的老年人提供正确的激励措施。在第三章中，我对RTS机制进行了调整，以使监管者为多种类型的公共健康保险设定费用。最后，我将讨论私有化方案如何应用于其他类型的社会保险。

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  • 作者

    Lonergan, Brian Edmund.;

  • 作者单位

    Yale University.;

  • 授予单位 Yale University.;
  • 学科 Economics Theory.
  • 学位 Ph.D.
  • 年度 2000
  • 页码 161 p.
  • 总页数 161
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 经济学;
  • 关键词

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