期刊Journal of Public Economics 2025年（下）保险精选文章目录与摘要｜保险学术前沿

声明：本系列文章基于原期刊目录和摘要内容整理而得，仅限于读者交流学习。如有侵权，请联系删除。

期刊介绍：

《Journal of Public Economics》（公共经济学杂志）是一本专注于公共经济学领域的学术期刊。该期刊自1972年成立以来，涉及的主题包括税收政策、公共支出、社会保障、公共选择理论、环境经济学、劳动经济学、教育经济学、卫生经济学、城市经济学和发展经济学等。它探讨了公共政策的效率和分配问题，以及需求者、供应者和其他卫生保健机构的行为模型。该刊每年发行12期，平均每期发表10篇左右，2024年影响因子为3.5。

本期看点：

●失业保险可以通过跨网络的风险共担来提高福利，而不会减少网络内部通过非正规保险进行的风险共担。

●雇主提供的医疗保险通常包含受抚养人（如子女）的覆盖条款。延长受抚养人医保资格期限，既提高了受抚养人的参保率，也增强了父母的工作稳定性。

●现金转移支付项目有望缓解发达国家的"收入-健康陷阱",保障性收入的增加提升健康水平。

●患病成年人愿意为降低死亡风险支付的每质量调整生命年（QALY）价值几乎是健康成年人的两倍，且降低重病风险与降低轻病风险的价值相近。

●生前给予继承人的馈赠规模可观，且对税收政策高度敏感。实施税收优惠的馈赠政策意味着，实现遗产税收最大化的统一税率上限为37%。

●基于韩国数据，养老金发放当周的死亡率下降1.2%至1.4%。与月度发放相比，金额较小但发放频率更高的养老金支付模式可能带来更强的死亡率降低效应。

●营销支付导致医生开始治疗预测死亡率较低的癌症患者。尽管支付导致抗癌药物支出增加，但患者死亡率并未出现相应改善。

※ 本期目录

●挤出群众支持？正规与非正规保险之间的替代关系

●受抚养人医疗保险覆盖与父母的工作锁定效应：基于《平价医疗法案》的证据

●现金转移支付对健康的影响：基于芬兰基本收入实验的证据

●健康风险与生命价值

●财富、馈赠与临终遗产规划

●养老金收入领取对短期死亡率与医疗资源利用的影响：基于韩国的证据

●无功而返：向医生推销抗癌药物虽增加处方量却未能降低死亡率

Crowding out crowd support? Substitution between formal and informal insurance

挤出群众支持？正规与非正规保险之间的替代关系

作者

Kyle Coombs（瓦萨学院）

摘要：Interpersonal gifts and loans play an underexplored informal insurance role in high-income countries, posing challenges for social insurance policy design. I examine informal support via person-to-person (P2P) payment platforms using a survey-linked administrative bank transaction dataset covering low-income US users with job loss. Event study estimates show average monthly P2P inflows increase by 1.1 % of lost income one month after job loss before returning to baseline over 10 months. Single mothers receive the largest increases, as do those with high prior earnings or those living in high-income areas. Exploiting three plausibly exogenous changes to federal pandemic UI policy, I estimate that an additional dollar of UI benefits crowds out at most $0.05 of informal transfers. These results imply that UI can raise welfare by pooling risk across networks without reducing within-network risk pooling through informal insurance.

人际馈赠与借贷在高收入国家中扮演着尚未被充分研究的非正规保险角色，这给社会保险政策设计带来了挑战。本文利用一项关联调查的银行交易行政数据集，研究了通过个人对个人（P2P）支付平台提供的非正规支持，该数据集覆盖了经历失业的美国低收入用户。事件研究估计表明，失业一个月后，平均每月P2P流入资金增加至收入损失的1.1%，随后在10个月内逐渐回归基线水平。单身母亲、先前收入较高者或居住在高收入地区的人获得的资金增幅最大。通过利用联邦疫情期间失业保险政策的三项看似外生的变化，估计每增加1美元的失业保险福利，最多挤出0.05美元的非正规转移支付。这些结果表明，失业保险可以通过跨网络的风险共担来提高福利，而不会减少网络内部通过非正规保险进行的风险共担。

原文链接：https://www.sciencedirect.com/science/article/pii/S0047272725001975

Dependent insurance coverage and parental job lock: Evidence from the Affordable Care Act

受抚养人医疗保险覆盖与父母的工作锁定效应：基于《平价医疗法案》的证据

作者

Hannah Bae（斯坦福大学），Katherine Meckel（加利福尼亚大学），Maggie Shi（芝加哥大学）

摘要：Coverage for dependents is a standard feature of employer-sponsored insurance. While prior work shows that employees trade off job mobility for their own coverage, less is known about the intra-family spillovers of dependent coverage on parental labor supply. We study this question using a large panel of employer-based insurance claims that links dependent enrollment to a proxy for parental job retention. We use a regression discontinuity design that exploits a sharp change in the duration of dependent eligibility by birth month under the Affordable Care Act. We find that additional dependent insurance eligibility increases both dependent take-up and parental job retention. This “job lock” effect is strongest among parents more likely to be on the margin of a job exit, for families that place higher value on dependent coverage, and employees of firms offering a broader range of insurance options.

雇主提供的医疗保险通常包含受抚养人（如子女）的覆盖条款。虽然已有研究表明，员工可能为维持自身医保而牺牲职业流动性，但受抚养人医保覆盖对父母劳动供给产生的家庭内部溢出效应，学界却知之甚少。本研究利用一个大型雇主医保理赔面板数据集，将受抚养人的参保情况与父母工作留任的代理指标相关联，对这一问题展开探讨。我们采用断点回归设计，基于《平价医疗法案》中依据出生月份导致的受抚养人资格期限突变进行分析。研究发现，延长受抚养人医保资格期限，既提高了受抚养人的参保率，也增强了父母的工作稳定性。这种"职业锁定"效应在以下群体中尤为明显：更可能处于离职边缘的父母、对受抚养人医保覆盖估值更高的家庭，以及所在企业提供更广泛保险选择的员工。

原文链接：https://www.sciencedirect.com/science/article/pii/S0047272725001379

Health effects of cash transfers: Evidence from the Finnish basic income experiment

现金转移支付对健康的影响：基于芬兰基本收入实验的证据

作者

Kari Hämäläinen（VATT经济研究所），Miska Simanainen（芬兰社会保险研究所），Jouko Verho（斯德哥尔摩大学）

摘要：This study provides causal evidence that cash transfer programs have the potential to alleviate the income–health trap in advanced countries. We analyze the Finnish basic income experiment, which replaced the minimum unemployment benefits with a guaranteed income for 2,000 randomly selected unemployed persons during the years 2017–2018. The guaranteed income removed all job–search requirements, but participants could still choose to claim unemployment benefits and comply with related obligations. The experiment also increased average income by 9%–11%, for two reasons: basic income payments overlapped with benefits due from the pre-experiment period, and basic income was not tapered against labor earnings. Using register data on all prescription medications and secondary care visits, we find that the experiment reduced psychotropic drug use by 8%–11%. Our results also suggest a decline in outpatient mental health visits for secondary care. No effects were detected for other health outcomes. Since most participants opted out of the unconditionality aspect of the experiment and continued to claim unemployment benefits, we attribute the observed health effects primarily to the increased income.

本研究提供了因果证据，表明现金转移支付项目有望缓解发达国家的"收入-健康陷阱"。我们分析了芬兰的基本收入实验——该实验在2017至2018年间，将2000名随机选取的失业者的最低失业福利替换为保障性收入。保障性收入取消了所有求职要求，但参与者仍可选择申领失业福利并履行相关义务。实验还使平均收入提高了9%-11%，原因有二：基本收入支付与实验前阶段的应得福利存在重叠，且基本收入不随劳动收入增加而递减。通过使用包含所有处方药和二级医疗就诊记录的登记数据，我们发现实验使精神类药物使用量降低了8%-11%。结果还表明二级医疗门诊中的心理健康就诊有所减少。其他健康指标未发现显著影响。由于大多数参与者未选择实验的无条件性条款而继续申领失业福利，我们将观察到的健康效应主要归因于收入增加。

原文链接：https://www.sciencedirect.com/science/article/pii/S0047272725001781

Health risk and the value of life

健康风险与生命价值

作者

Daniel Bauer（威斯康星大学麦迪逊分校），Darius Lakdawalla（南加州大学），Julian Reif（伊利诺伊大学）

摘要：We extend the conventional life-cycle framework for valuing health and longevity improvements to a stochastic setting with multiple health states and apply it to data on mortality, quality of life, labor earnings, and medical spending for adults with different comorbidities. We find that sick adults are willing to pay nearly twice as much per quality-adjusted life-year (QALY) to reduce mortality risk as healthy adults, and that reducing the risk of serious illness is valued similarly to reducing the risk of mild illness. Our results provide a rational explanation for why people oppose a single threshold value for rationing care and why they invest less in prevention than in treatment.

我们将传统的用于评估健康和寿命改善的生命周期框架扩展至包含多重健康状态的随机情境，并将其应用于具有不同合并症的成年人在死亡率、生活质量、劳动收入及医疗支出方面的数据。研究发现，患病成年人愿意为降低死亡风险支付的每质量调整生命年（QALY）价值几乎是健康成年人的两倍，且降低重病风险与降低轻病风险的价值相近。这一结果从理性角度解释了为何人们反对采用单一阈值进行医疗资源分配，以及为何在预防方面的投入低于治疗投入。

原文链接：https://www.sciencedirect.com/science/article/pii/S0047272725000441

Wealth, gifts, and estate planning at the end of life

财富、馈赠与临终遗产规划

作者

David Sturrock（伦敦大学学院），Stefan Groot（荷兰合作银行），Jan Möhlmann（荷兰经济政策分析局）

摘要：We show that gifts made to heirs before death are substantial and highly responsive to taxation. Using intergenerationally-linked administrative data from the Netherlands and exploiting variation in the timing of death, we find that single people (including widows) with children transfer around 10 % of their wealth to their children in anticipation of death. This is almost entirely in the form of tax-exempt gifts. Exploiting bunching at kink points in the gift tax schedule and a reform to inheritance taxation, we estimate elasticities of gifts and wealth to taxation and find that tax-avoidance accounts for at least a significant minority of this deathbed giving. The ability to make tax-favoured gifts means that the revenue-maximising flat inheritance tax rate is at most 37 %. Equalising the tax rate on deathbed gifts and inheritances at death would increase revenues raised from singles by 10 %.

我们的研究表明，生前给予继承人的馈赠规模可观，且对税收政策高度敏感。基于荷兰跨代关联的行政数据，并利用死亡时间的自然变动进行分析，我们发现拥有子女的单身人士（包括丧偶者）在预期死亡前会向子女转移约10%的财富，且几乎全部以免税馈赠形式进行。通过利用赠与税制中的税率拐点聚集现象及一项遗产税改革政策，我们估算了馈赠与财富对税收的弹性，发现避税动机至少是此类临终馈赠行为的重要成因之一。实施税收优惠的馈赠政策意味着，实现遗产税收最大化的统一税率上限为37%。若将临终馈赠与死亡时继承的税率统一，单身人士群体的相关税收收入可增加10%。

原文链接：https://www.sciencedirect.com/science/article/pii/S0047272725001902

Short-term mortality and healthcare utilization consequences of pension income receipt: Evidence from South Korea

养老金收入领取对短期死亡率与医疗资源利用的影响：基于韩国的证据

作者

Mimi Jeon（韩国公平交易委员会经济分析局），Seonghoon Kim（新加坡管理大学），Kanghyock Koh（高丽大学）

摘要：We examine short-term consequences of pension income receipt on mortality and healthcare utilization within the monthly payment cycle. Using the national death registry data of South Korea, we document that the mortality rate decreases by 1.2–1.4 percent in the week of the disbursement date. The mortality-reducing effects are larger for causes of death that could have been avoided through timely and effective healthcare interventions. Using healthcare claims data, we document that the number of hospital admissions increases during the disbursement week. We provide suggestive evidence of greater mortality-reducing effects from a smaller but more frequent disbursement than from a monthly disbursement.

我们考察了在月度养老金发放周期内，收入领取对死亡率和医疗资源利用的短期影响。基于韩国的全国死亡登记数据，我们发现养老金发放当周的死亡率下降1.2%至1.4%。对于那些通过及时有效的医疗干预可避免的死亡原因，死亡率降低的效应更为明显。通过分析医疗报销数据，我们发现发放当周的住院人数有所增加。初步证据表明，与月度发放相比，金额较小但发放频率更高的养老金支付模式可能带来更强的死亡率降低效应。

原文链接：https://www.sciencedirect.com/science/article/pii/S0047272725001884

Nothing for something: Marketing cancer drugs to physicians increases prescribing without improving mortality

无功而返：向医生推销抗癌药物虽增加处方量却未能降低死亡率

作者

Colleen Carey（美国国家经济研究局），Michael Daly（康奈尔大学）a，Jing Li（华盛顿大学）

摘要：Physicians commonly receive marketing-related transfers from drug firms. We examine the impact of these relationships on the prescribing of physician-administered cancer drugs in Medicare. We find that prescribing of the associated drug increases 4% in the twelve months after a payment is received, with the increase beginning sharply in the month of payment and fading out within a year. A marketing payment also leads physicians to begin treating cancer patients with lower predicted mortality. While payments result in greater expenditure on cancer drugs, there are no associated improvements in patient mortality.

医生通常接受来自制药公司的营销相关款项。我们研究了这种关系对联邦医疗保险（Medicare）中医生处方开立自费抗癌药物的影响。研究发现，在收到款项后的12个月内，相关药物的处方量增加4%，这一增长从支付当月开始显著上升，并在一年内逐渐消退。营销支付还导致医生开始治疗预测死亡率较低的癌症患者。尽管支付导致抗癌药物支出增加，但患者死亡率并未出现相应改善。

原文链接：https://www.sciencedirect.com/science/article/pii/S004727272500009X

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