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健康保险的提供与企业的国际竞争力无关  

2009-05-30 18:49:38|  分类: 默认分类 |  标签: |举报 |字号 订阅

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Monday, May 25, 2009

The Healthcare-Competitiveness Fallacy


美女同事
[译]

A common argument, often made by ostensibly sophisticated commentators, is that the United Statesneeds to reform its health care system to maintain its internationalcompetitiveness. Regardless of your views of health care reform, thisparticular argument is, to put it bluntly, nonsense. Long ago, PaulKrugman wrote a nice piecedemolishing the whole concept of international competitiveness as amotive for national economic policy. More recently, the CongressionalBudget Office has done a nice job explaining why the idea ofinternational competitiveness as a reason for health care reform isfallacious. The passage below, from page 167 of the CBO analysis, is written in the CBO's traditional understated way, but the point is clear:

有一个普遍的观点,经常被一些表面上高深莫测的评论家所提及,那就是:美国需要改革她的保健体系,以保持国际竞争力。无论对保健改革持有什么样的观点,坦白地讲,这个观点都是胡说八道。很久以前,Paul Krugman写过一篇好文章,彻底推翻了将国际竞争力作为一个国家经济政策的驱动因素之一。最近,国会预算办公室(Congressional Budget Office, CBO)做了件好事,解释了为什么国际竞争力作为保健改革的原因是错误的。下面一段,开始于CBO分析文章的167页,CBO传统的简朴文风,不过观点清晰明白:

International Competitiveness

Someobservers have asserted that domestic producers that provide healthinsurance to their workers face higher costs for compensation thancompetitors based in countries where insurance is not employment basedand that fundamental changes to the health insurance system couldreduce or eliminate that disadvantage. However, such a cost reductionis unlikely to occur, except in the short run.

一些观察家坚称,国内生产商,为员工提供了健康保险,就面临着更高的薪酬成本。因为它们竞争对手所在的国家,没有基于员工的保险。如果健康保险体系能发生根本性的转变,不利的状况就会减少或者消除。然而,这种成本缩减不太可能发生,除非是在短期内。

Theequilibrium level of overall compensation in the economy is determinedby the supply of and the demand for labor. Fringe benefits (such ashealth insurance) are just part of that compensation. Consequently, thecosts of fringe benefits are borne by workers largely in the form oflower cash wages than they would receive if no such benefits wereprovided by their employer.

一个经济体中,全部薪酬的均衡水平,是由劳动力的供求来决定的。附加的福利(如健康保险)仅仅是薪酬的一部分。因而,附加福利的成本是雇员承担的,大部分采取了更低现金工资的形式。如果雇主没有提供这种福利,他们的工资会更高。

Replacingemployment-based health care with a government-run system could reduceemployers’ payments for their workers’ insurance, but the amount thatthey would have to pay in overall compensation would remain essentiallyunchanged. Even though changes to the health care system could havevarious effects on the supply of labor, the underlying amount of laborsupplied at any given level of compensation would hardly be affected bya change in the health care system. As a result, cash wages and otherforms of compensation would have to rise by roughly the amount of thereduction in health benefits for firms to be able to attract the samenumber and types of workers.

用政府运营的体系,来取代基于雇佣的保健体系,会降低雇主对于员工保险的支出。但是,他们要支付的薪酬总额,却基本不变。即使,保健体系的改变对于劳动力的供给有不同的影响,对于任何一个给定的薪酬水平,劳动力供给的潜在数量,基本不受保健体系变化的影响。结果,现金工资及其他形式的薪酬会上升,幅度大致相当于健康福利的减少,这样才能吸引到相同数量和类型的员工。

Compensationcould take some time to adjust to its market-clearing level (the pointat which supply and demand are equal). During that time, firms thatformerly provided health benefits—especially firms that employ workersunder multiyear contracts—could experience substantial reductions inlabor costs, which would boost their profits temporarily. But those firms would experience no permanent change in their competitive status.

花上一段时间,薪酬就会调整到市场出清的水平(也就是供求相等的水平)。在这段时间,以前提供健康福利的企业――特别是与员工签有多年期合同的企业――在劳动力成本上将经历锐减,随即导致利润短暂地飙升。然而,在竞争状况方面,这些企业不会发生一劳永逸地改变。

Be ready: This fallacy may well be rearing it ugly, and illogical, head in the days to come.

看好了:这种丑陋的、荒谬的错误会在日后有所抬头。

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