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自20世纪70年代医疗储蓄账户思路产生,已有美国、中国、南非和新加坡4个国家建立自愿参加和强制参加的两大类医疗储蓄账户计划。文章对比了这4个国家的医疗储蓄账户制度设计要点,并随后对除我国外的其余3个国制度运行情况进行文献综述。研究发现,4国医疗储蓄账户除参加原则和一些细节设计上,基本设计方面相仿,但其他国家在制度细节方面的设计更为完善。对南非、新加坡和美国医疗储蓄账户计划实施效果的讨论发现理论和实践存在差距。医疗储蓄账户能否控制医疗费用增长、促进效率和影响公平方面都存在争论。
Since the concept of medical savings accounts in the 1970s, two major categories of medical savings account schemes have been set up in the United States, China, South Africa and Singapore to voluntarily participate and to participate. The article compares the design points of the medical savings account system in the four countries and then reviews the literature on the operation of the other three countries except China. The study found that the medical savings accounts in the four countries have similar basic design aspects except for the principle of participation and some details of the design, but the design of other countries in terms of system details is more perfect. A discussion of the effect of the planned medical savings account in South Africa, Singapore and the United States found a gap between theory and practice. There is a debate over whether medical savings accounts can control the growth of health care costs, promote efficiency and affect fairness.