关于中国现行医疗制度改革的几点思考

在中国目前的医疗体制下,医患双方是医疗服务市场的博弈的主体。由于医疗服务的特殊性,使患者在医患双方博弈中明显处于弱势地位。中国目前的报销制是:患者先就医,交全款,再到医保机构报销。这可看成患者与医院(医生)和医保机构之间的双重博弈,而在两次博弈中,患者总是处于信息弱势地位,利益受到双重侵害。引入第三方购买有效控制的只是医患信息不对称导致医疗服务提供方的道德风险,而对医患信息不对称导致医疗服务需求方的道德风险作用不大,并有可能扩大这种道德风险。

Considerations on the Reform of Medical System in China

Under the present medical system,hospital and patients are the main body of the game of the medical service market.Owing to the peculiarity of medical service,the patients are in an unfavorable position in this game.The present reimbursement regulation is that the patients get the medical treatment and pay the full cost,and then submit the expense account to the medical organization.This can be viewed as a double game between the hospital and medical insurance organization.In these two games,the patients are always in an unfavorable position of gaining information.The introduction of the Third Side Purchase can only control the moral risk from the supplier of this medical service caused by the imbalance of hospital-patient information,but have little effect on the moral risk from the demander side of this service and maybe deepen this moral risk.