第三方购买、内部市场与过度医疗--基于不完全信息的动态博弈视角  

On the Relationship among the Third Part Purchase, Internal Market and Overtreatment: Based on a Dynamic Game of Incomplete Information Perspective

作　　者：李文溥[1] 谢攀[2] 储成亮 

机构地区：[1]教育部人文社科重点研究基地--厦门大学宏观经济研究中心 [2]陕西师范大学国际商学院 [3]民生通惠资产管理有限公司

出　　处：《学术研究》2017年第7期83-94,共12页Academic Research

基　　金：国家社科基金重大项目“需求结构转换背景下提高消费对经济增长贡献研究”(15ZDC011);国家社科基金青年项目“供需均衡视角下的中国潜在经济增长率测算与增长要素分析”(16CJL011)的阶段性成果

摘　　要：在不完全信息动态博弈框架下,分析基于"第三方购买"构建的"内部市场"对纠正过度医疗的影响机制发现:(1)当某种疾病发病率较高且一旦发病,病情严重的概率也较高时,混同均衡占优;(2)"内部市场"构建后,引入保险机构作为独立的第三方,对医治过程实施监督抽查能显著降低混同均衡出现的概率,减少医生欺骗行为;(3)数值模拟结果表明混同均衡成立时临界值上升的幅度随病症轻重程度的变化呈现显著的"倒U型",整体而言,"内部市场"降低了医疗资源误置,对轻症过度医疗的抑制效应显著高于重症,对住院过度医疗的抑制效应强于门诊。本文据此设计了一个兼顾医生、患者、医疗保险费收集者、医保基金公司等各方利益且充分利用市场机制的新医保体制。Under the framework of dynamic game of incomplete information, the paper analyzes the mechanism of building internal market's impact on overtreatment. It draws out several conclusions. First, pooling equilibrium dominates the game when the incidence of disease is high and its serious probability is high as well. Social welfare will lose in such situation. Secondly, after building internal market, it is the inspection and supervision from insurance agency, an unattached third part that can decrease the possibility of appearance of pooling equilibrium, and reduce doctors' fraudulent behavior. Thirdly, numerical simulation indicates that the rise of threshold value presents an appearance of apparent inverted U shape when the pooling equilibrium exists. In general, building up internal market lowers the medical resources misallocation. For instance, compared with critical disease, depressing effect has a major consequence within trifling ailments. Compared with clinic treatment, depressing effect has a greater consequence within treatment in hospital. Inspired by the above, we design a newly medical and health care insurance system, which reconciles all parts' benefits including doctors, patients, medical insurance premium collectors, medical insurance companies and so on.

关 键 词：信任品 过度医疗 内部市场 混同均衡 

分 类 号：F062.6[经济管理—政治经济学]