我国医疗体制改革的前瞻研究:新医保一体化——基于企业交易费用理论的分析范式  

A Forward-looking Research into the Medical System Reform in China:Integration of New Hospitalization Insurance——An Analysis Paradigm Based on Enterprise Transaction Cost Theory

作　　者：马本江[1] 

机构地区：[1]中南大学商学院,湖南长沙410083

出　　处：《经济经纬》2011年第1期94-99,共6页Economic Survey

基　　金：国家自然科学基金项目(71072078);国家教育部博士点新教师基金项目(200805331059);教育部人文社会科学基金项目(09YJC790260);湖南省哲学社会科学基金项目(08YBA021)

摘　　要：医疗改革问题的实质就是寻找一个交易费用最小化的医疗服务定价机制,使医疗服务的质量和成本能够被其价格准确或近似地反映出来。在当前医院仅提供医疗服务的边界上,无论是服务供方的市场化还是行政化,都存在医疗定价扭曲问题;服务供方市场化前提下,当医院的边界扩大到兼提供医疗服务、医疗保险、因病伤残保险三项业务一体化即新医保一体化情形时,就能实现药单费用和因病伤残成本的内部化,使医疗服务定价扭曲问题得以解决;如果走服务供方行政化路线,即便实施了新医保一体化,也无法从根本上解决医疗服务定价扭曲问题,应当加以排除。由此得出结论:服务供方市场化前提下的新医保一体化是当前医疗体制改革值得考虑的模式。The essence of medical reform is to set up a medical service pricing mechanism which can minimize transaction costs so that the quality and the costs of medical service can be reflected by its price accurately and approximately. When hospital nowadays provides medical service, whether the service suppliers apply market mechanism or administration mechanism, price distortions exist. When the hospital expands to supply not only medical service, but also medical insurance and disability insurance due to illness, that is, the integration of new hospitalization insurance, drug bills and disability due to illness costs can be internalized and price distortions can be solved as well. If service suppliers adopt administration mechanism, even though the integration of new hospitalization insurance is implemented, it can not solve price distortions in essence, and should be excluded. It is concluded that under the premise of service sup- pliers adopting market mechanism, the integration of new hospitalization insurance is worth considering as a possible model of medical reform.

关 键 词：新医保一体化 间接定价理论 诱导需求 道德风险 委托代理 

分 类 号：F840.684[经济管理—保险]