Tax incentives and the decision to purchase long-term care insurance

This paper studies the impact of the tax incentive prescribed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on individuals' long-term care insurance purchasing behavior. Using data from the Health and Retirement Study, we find that the tax incentive in HIPAA increased the take-up rate of private LTC insurance by 3.3 percentage points, or 25%, for those eligible. Despite this seemingly strong response, our results imply that even an above-the-line tax deduction would not increase the coverage rate of seniors beyond 13%, indicating that tax incentives alone are unlikely to expand the market substantially. We also present, to our knowledge, the first estimate of the price elasticity of demand for LTC insurance of around ? 3.9, suggesting that demand is highly elastic at the current low ownership rate. Finally, we evaluate the net fiscal impact of the tax incentive and find that the tax deductibility of LTC insurance premiums leads to a net revenue loss for the government, as the reduced tax revenue from granting the tax incentive exceeds the savings in Medicaid's LTC expenditures.     

Courts,scheduled damages,and medical malpractice insurance

We study how the functioning of the judicial system affects the availability and affordability of medical liability insurance, as proxied by the number of insurers and the premiums paid. We use two unique datasets collected in Italy from 2000 to 2010. Using the first dataset—insurance contracts for hospitals—we estimate the average treatment effect of schedules on insurers and premiums paid, conditional on judicial efficiency and proxied by different measures. Our identification rests on the partial overlap between healthcare districts and judicial districts, meaning that the caseload of a court and malpractice events at the healthcare provider level are not perfectly correlated. On average, the adoption of schedules does not produce any significant effect on insurers or on premiums paid. However, adopting schedules has a robust and significant effect on the number of insurers, but only in inefficient courts. We further investigate these findings using a second dataset comprising 17,578 malpractice insurance claims. We find evidence of a composition effect among claims that is triggered by higher levels of judicial inefficiency: As a court’s inefficiency increases, the likelihood for a case to not be decided on the merits decreases and the levels of reserve and recovery per claim decrease.     

Health insurance and the demand for medical care: evidence from a randomized experiment.

We estimate how cost sharing, the portion of the bill the patient pays, affects the demand for medical services. The data come from a randomized experiment. A catastrophic insurance plan reduces expenditures 31 percent relative to zero out-of-pocket price. The price elasticity is approximately -0.2. We reject the hypothesis that less favorable coverage of outpatient services increases total expenditure (for example, by deterring preventive care or inducing hospitalization).     

大学生医疗保险现状研究

随着2009年国务院颁布将大学生纳入城镇居民基本医疗保险政策,各高校陆续开始实施新的大学生医疗保险政策。从分析我国大学生医疗保险发展的历程入手,探讨了新制度中存在的问题,并提出了相应的可行性政策建设。     

统筹城乡基本医疗保险制度的路径研究

我国虽然已经建立起覆盖全民的基本医疗保险制度,但同时我们也该看到,由于制度的历史性问题,该保障制度存在非常明显的碎片化特征。具体说,就是我国基本医疗保险制度参保人群的区分是以是否就业、不同行政区以及城市与农村的差别为参照的,其能获得的保险待遇、基金管理都存在巨大差异,造成了城乡医疗保障之间的不公平现象,缺乏可持续性。为解决基本医疗保险制度的“二元”性,我国应当尽快推进统筹城乡医疗保险制度,因此,将主要探讨城乡基本医疗保障制度现状,以及统筹城乡基本医疗保障制度实施路径,并提出具体的整合框架与建议。     

当前我国医疗保险制度存在的问题及解决途径探析

中国特色的医疗保险制度在我国初步建立,由于历史的和现实的原因,还存在着一些问题,不能完全满足广大人民群众的需求,需要在实践中逐步加以改进和完善。通过系统总结当前我国医疗保险制度存在的突出问题,并对其存在的原因进行深入分析,从而提出建设性的对策建议。     

Gender and the demand for medical care

The consumption of a set of diverse medical services is analysed in an effort to determine the sources of high utilization by women.Unlike previous studies of gender and the demand for medical services,the range of services investigate allows us to draw conclusions about the influence of physicians as agents.We use a modified version of the almost-ideal demand model in the emperical analysis which,unlike the double-log quadratic, or linear demand models, is consistent with constraints imposed by economic theory.Through decomposition of the variance, it was found that if women reported the same series of health indicators as men. their use of most services would fall below that of men.     

Tax Overpayments, Tax Evasion, and Book-Tax Differences

A strictly risk-averse manager makes joint decisions on a firm's tax payments and book profit declarations according to accounting standards. It is analyzed how the incentives to overpay or evade taxes and to inflate book profits are influenced by (1) the composition of the manager's remuneration, (2) the ability to control the manager's actions, (3) the costs of making untruthful profit declarations, and (4) the tax rate. If the firm's owner or the government take into account these effects when pursuing their own objectives, the changes in tax payments and book profit declarations become theoretically more ambiguous.     

试论我国医疗保险费用控制

建立有效的医疗保险费用控制机制,既是社会医疗保险系统改革的核心内容,也是商业健康保险所必须解决的一个问题.医疗保险的核心是医疗费用,医疗保险费用控制的根本性问题可以归结为医疗费用控制问题.本文基于历史分析视角,通过分析我国医疗保险费用控制的过程及效果,结合对影响医疗费用上涨因素的剖析,同时借鉴发达国家经验,对如何有效控制医疗保险费用上涨的路径选择提出对策建议.     

浅谈对“医疗保险基金会计核算改革”的理解

随着政府管理理念的变化和医疗保险体制改革的不断深化,医疗保险基金核算应根据不同的业务,采取收付实现制和权责发生制相结合的会计核算基础,以便准确、全面地反映医疗保险基金的实际运行情况,有利于预算管理。     

Race, ethnicity, and insurance as determinants of epidural use: analysis of a national sample survey

Despite widespread availability of pain interventions in childbirth, for most women, childbirth is associated with labor pain that exceeds expectations. Although epidural is superior to other medical interventions, the choice to use epidural still remains a matter of patient and doctor preference. Whether racial or ethnic characteristics influence preference of physician use or interact with insurance coverage is still unknown. This study used a large national sample of women to measure significant determinants of epidural use in order to discuss disparities in pain management. The findings suggest the need for nurse leaders to foster health policies that are sensitive to diversity and economics.     

Complex home care: Part 2- family annual income, insurance premium, and out-of-pocket expenses

Annual costs paid by families for intravenous infusion of home parenteral nutrition (HPN) health insurance premiums, deductibles, co-payments for health services, and the wide range of out-of-pocket home health care expenses are significant. The costs of managing complex chronic care at home cannot be completely understood until all out-of-pocket costs have been defined, described, and tabulated. Non-reimbursed and out-of-pocket costs paid by families over years for complex chronic care negatively impact the financial stability of families. National health care reform must take into account the long-term financial burdens of families caring for those with complex home care. Any changes that may increase the out-of-pocket costs or health insurance costs to these families can also have a negative long-term impact on society when greater numbers of patients declare bankruptcy or qualify for medical disability.     

Unemployment,insurance and smoking

Using recent state-level data from the United States, this article examines new influences on cigarette demand. In particular, we uniquely focus on the effects of unemployment and health insurance coverage on smoking. Results show that higher cigarette prices, a lack of health insurance and restrictions on smoking at home, all lead to reduced smoking. On the other hand, literacy, income, unemployment, workplace smoking restrictions, smokeless tobacco taxes and tobacco-producing states do not seem to have an appreciable impact. The magnitude of the price elasticity of demand is greater than that found in the pre-MSA era. Policy implications are discussed.     

内部控制、税收征管与企业税务风险

在我国税收征管不断加强的情况下,如何防范和化解企业税务风险成为一个急需解决的重要问题.理论分析表明,企业内部控制以及税收征管力度是影响企业税务风险的重要微观与宏观因素.利用手工搜集国家税务总局披露的各企业纳税信用评级数据进行实证检验,结果发现,内部控制质量越好的企业,企业税务风险越低;提高税收征管强度后,更容易发现企业税务风险;进一步研究表明,内部控制通过降低异常有效税率对企业税务风险产生作用,同时税收征管发现税务风险的作用主要体现在内部控制差的企业.因此,企业应建立良好的内部控制机制,加强涉税管理来抑制企业税务风险;税务部门应充分利用大数据等技术手段,提高税收征管质量,帮助企业降低税务风险;税务代理中介机构应加强行业自律,帮助企业提高内部控制水平.     

税收效率和公平原则的理论与税收完善

该文较深入地探析了税收的效率和公平原则的有关理论观点,并根据这两个理论原则和我国实际情况,对如何完善我国税制,其中包括要完善消费税、企业所得税、资源税、个人所得税、增值税、财产税,以及设置环境保护税和社会保障税等方面提出了有益的见解。     

税务违章行为辨析--论偷税、漏税、欠税、抗税的政策界定

我国现行税法对各种税务违章行为的界定极不严密,给实际违章鉴定工作留下许多可以“灵活”解释的余地。国家应进一步修改和完善《税收征管法》,重新明确界定各种税务违章行为,改变“偷税＝漏税＝欠税＝抗税”的状况,以确保税收征管的客观性和准确性,切实维护国家和纳税人的合法权益。     

Status and prospect of the Chinese trading scheme for carbon credits

Given the arduous progress in the international talk on climate change mitigation,there is still uncertainty in the continuation of the Clean Development Mechanism(CDM) after 2012.However,a number of countries have regarded market mechanisms as an important approach towards climate change.China’s 12 th Five-year Plan on National Economic and Social Development clearly states that China will set up and improve the system for statistical accounting of greenhouse gas emission and will gradually establish an emission trading scheme.It is expected that in the following couple of years China will develop its own policies on carbon trading and gradually establish its domestic emission trading market.The construction of China carbon market is to be promoted in a voluntary-to-mandatory and regional-to-national manner.China will firstly standardize and promote the trading of voluntary emission reductions,and will then encourage pilot provinces and cities as well as some key industries to implement a policy on emission allowance trading while at the same time facilitating the construction of infrastructural facilities for carbon market operation including climate change legislation and setting up a system for the measurement and verification of carbon emissions.China will also carry out international or bilateral cooperation with foreign carbon trading schemes based on the progress of international negotiation so as to set up a unified domestic carbon market that is linked to international carbon trading schemes.     

东道国税率、企业避税与跨国企业创新

为了更好地把握我国跨国企业在境外关联关系影响下创新活动的变化规律,文章将跨国企业境外关联特征纳入跨国企业创新行为的分析框架,以我国上市公司500强当中的355家A股上市公司2012-2017年的数据为研究样本,基于企业避税视角重点考察了东道国税率对我国跨国企业创新产出的影响及其机制.研究发现,当东道国平均税率下降时,跨国企业很有可能通过转移研发活动地点的方式将研发投入向境外转移,且这种避税行为所导致的创新数量减少大于研发可用资金增加所带来的创新数量增加,从而使跨国企业国内创新产出下降,并最终导致其整体创新产出水平的降低.此外,东道国税率对我国跨国企业创新的影响还受到知识产权所得税优惠制度的强化以及反避税制度的制约,且这种影响在不同所有权性质以及避税程度不同的企业当中具有差异性.因此,我国在设计创新激励税收政策时需要避免与其他国家或地区形成过大落差,减少跨国企业避税动机;同时要加强我国反避税措施的针对性以及与最新税收优惠制度的适配性;最后,考虑出台我国的专利盒制度,增强我国知识产权税收制度的国际竞争力.