A Study On Health Insurance Thought In The American Economic Review

Health insurance is a general term of commercial health insurance,public medical insurance and policy insurance.It is an important part of a country’s health security system.In 2016,China put forward the "Healthy China" program of action,which is a strategic decision to promote the all-round development of the people with the interests of the people at the core.However,since China’s health insurance industry started late,we need to learn from the successful experience of the pioneer countries.The author found that The American Economic Review is the journal with the longest time,the largest number of articles and the most abundant research topics on health insurance.Based on The American Economic Review,this paper analyzes the development and evolution of health insurance ideas and provides theoretical support for the development of health insurance in China.The introduction part of this paper expounds the basis of topic selection,research significance,research framework and other aspects.First,the authors translated and analyzed 161 articles on health insurance published before 2020 in five leading economic journals.It is found that the health insurance research articles in The American Economic Review account for 63% of the five authoritative journals.The research topics cover all aspects of health insurance,which is an important vane of health insurance theory research.Therefore,it is feasible to choose an authoritative journal with a history of one hundred years as the research object of health insurance thought.Secondly,the significance of the research.The thematic study of health insurance literature in The American Economic Review will provide new materials and subject directions for domestic health insurance research.At the same time,the construction and development of health insurance system from an international perspective is helpful to explore the development direction of health insurance suitable for China’s national conditions.In terms of research framework,this paper systematically combs the articles on health insurance published in The American Economic Review from 1911 to 2020.At the same time,it summarizes three time stages of the development and change of its research topics and thoughts and theories.This paper reviews in detail the monographic research papers on health insurance in The American Economic Review from four aspects: demand for commercial health insurance,supply of commercial health insurance,public health insurance and national health care reform.The first chapter makes a statistical analysis of the variation trend of the number of health insurance research articles in The American Economic Review from 1911 to2020,and the authors’ academic contributions.Then,three stages of the change of the research theme are summarized: In the first stage,from 1911 to 1970,the health insurance research articles were mainly short book reviews with few articles.In the second stage,from 1970 to 2000,there were 22 academic papers on health insurance research,mainly on commercial health insurance.The third phase,from 2000 to 2020,included 70 academic papers on health insurance,the research topics include:coverage of commercial health insurance,competition and efficiency of commercial health insurance market,public health insurance plan,Medicare prescription drug plan,Medicare Advantage Plan,and national health care reform.The basic conclusion is that the study of health insurance theory and the practice of insurance industry are developing together.Chapter two and chapter three introduce the research of commercial health insurance in The American Economic Review from the perspective of demand and supply.From the demand side,a total of 10 articles from 1911 to 2020 discussed the demand for commercial health insurance.The core issue of the research was how to increase the coverage rate of health insurance and discussed the factors affecting the coverage rate of health insurance.The specific contents included: The influence of characteristics of insurance providers(policy design,premium),characteristics of insurance consumers(family insurance cost,personal financial cost,risk preference of elderly consumers),macro-environmental factors(rate regulation and regulation,other social insurance,government tax policies,aging population)on health insurance demand.From the supply side,1911-2020,a total of 18 article discusses the issue of the supply of commercial health insurance,the concrete content includes: the commercial health insurance market efficiency analysis(market failure,system efficiency,the problem of choose and buy),the commercial health insurance market cost and quality analysis,commercial health insurance companies,hospitals,the game between the managed care organization).The fourth chapter of this paper analyzes the research on public health insurance in The American Economic Review.With an aging population,expanding insurance coverage and rapidly rising medical costs,the government is under enormous financial pressure.On the one hand,the government improves patient cost sharing from the demand side and introduces the prospective reimbursement system from the supply side to reduce medical costs.On the other hand,the government is increasingly introducing market mechanism into traditional medicare plans,hoping to improve the efficiency of medical service delivery through market competition and market selection.From 1911 to 2020,a total of 38 articles were published on medicare,including: cost control of public health insurance plan and its impact on health care market;Risk adjustment for Medicare Advantage plans;Consumer choice issues in medicare prescription drug plans and drug price control issues.The fifth chapter of this paper analyzes the research on national health care reform in The American Economic Review.After the outbreak of the financial crisis in2008,the Voice of the American people for healthcare reform became increasingly high.The Obama administration passed the Patient Protection and Affordable Care Act(ACA)on March 23,2010.The main goal of ACA reform is to expand health insurance coverage and reduce costs.From 2006 to 2020,a large number of academic achievements published in The American Economic Review discussed the policy issues of the Obama administration before and after the healthcare reform,including:The implementation effect of the core policies of Obama’s healthcare reform(compulsory insurance policy,premium subsidy policy for low-income people,health insurance exchange),and the macro impact of Obamacare on the insurance market(insurance coverage,insurance price,and other public insurance).The conclusion of this paper summarizes the statistical characteristics of health insurance research in The American Economic Review,its influence and enlightenment on the theoretical research of health insurance in China,and puts forward some suggestions for the development of health insurance in China.First,the number of The American Economic Review articles on health insurance increased from 1911 to 2020,and the authors showed a trend of collaboration from individuals to groups.The articles were of high academic value,but there were geographical limitations.Secondly,the research results about medicare in The American Economic Review are the most important reference frame for Chinese academic research on health insurance.Thirdly,the health insurance research in The American Economic Review has great enlightenment for the research of Health insurance theory in China:pay attention to multi-disciplinary research perspective and research methods;Strengthening quantitative research;Combined with the actual situation of China,strengthen the information asymmetry of long-term care insurance,commercial health insurance market,health insurance supply side research.Finally,the health insurance research in The American Economic Review has important implications for the development of health insurance practice in China: prudent introduction of market mechanism;Government should control medical costs through incentives and regulation;Actively develop the health management market;Explore new development mode of public-private partnership in service outsourcing market;On the basis of China’s current social economy,we should make trade-offs among the three goals of health reform: "accessibility","cost" and "quality".