医疗保险与医药价格改革  

The Medical Insurance and Medical Care Price Reform

作　　者：王震[1] 

机构地区：[1]中国社会科学院经济研究所,北京100836

出　　处：《中国医疗保险》2015年第8期14-16,共3页China Health Insurance

基　　金：国家社科基金项目<医保付费机制创新与公立医院改革研究>(14BGL145)的阶段性成果

摘　　要：在全民医保背景下,医保不仅是风险分散的手段,而且作为医疗服务的主要付费方和需方代理人,应在医药价格形成中充分利用市场机制,通过参与价格形成发挥医疗资源配置者的功能。当前的主要障碍:一是医药的行政定价;二是供方事实上的行政垄断。政策突破口是建立医保医师制度,打破公立医院垄断,充分利用市场机制形成合理的医药定价机制。Under the background of universal health care, medical insurance should play role in allocating medical resources amongst different parties in medical industries by involving in price forming system, since medical insurance is not only a way of risk diversifying, but also the main payers and the agents of the insured. However, the basic medical insurance in China is excluded from the medical price forming system, because of the monopolistic position of public hospitals in medical services and governmental price forming. The ways to solve this problem is to build a direct physician contracting system, break the monopoly of public hospitals, and construct a reasonable medical pricing system based on market mechanism.

关 键 词：全民医保 定价机制 价格改革 医保医师 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学]