Health care costs for U.S. employers have tripled over the past 20 years. Using firm-specific health expense data, I show that firms negatively adjust capital expenditures and R&D expenses in response to increases in health care costs. The effects are more pronounced for firms that are financially constrained, employ more high-skilled workers, and have less bargaining power relative to insurers. Furthermore, policy uncertainty surrounding health care costs is substantial and discourages capital investment. These findings suggest that an elevated level of health care costs and the associated uncertainty limit a firm’s ability to expand physically or through innovation.

中文翻译：

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医疗保健成本和企业投资

过去 20 年来，美国雇主的医疗保健费用增加了两倍。使用特定于公司的医疗费用数据，我发现公司会根据医疗保健成本的增加对资本支出和研发费用进行负面调整。对于财务受限、雇用更多高技能工人且相对于保险公司议价能力较低的公司来说，这种影响更为明显。此外，围绕医疗保健成本的政策不确定性很大，阻碍了资本投资。这些发现表明，医疗保健成本水平的升高以及相关的不确定性限制了公司实体扩张或通过创新扩张的能力。