破解医保控费障碍的法经济学研究

Study on Law and Economics in Solving Expense Control Barriers of Medical Insurance

文章旨在解决医保控费中的利益分配问题,在提出医保控费的最大障碍是医院利益的维护与医疗成本下降这对矛盾之后,从法律和制度两个方面对该问题的产生进行分析;最后提出解决此问题的对策是从法律和制度方面探索多元的支付方式及完善异地就医结算机制,并辅之以信息化建设、医务人员培训和医疗补偿机制建设等相关制度的完善.

The article aims to solve the problem of benefit distribution in the expense control of medical insurance.Firstly,we proposed that the biggest obstacle to the expense control of medical insurance was the contradiction between the maintenance of hospital benefits and the decline of medical costs.Secondly,we performed law and economic analysis of the problem.Finally,we suggested that the countermeasures to solve this problem were to explore diversified payment methods from the legal and institutional aspects and to improve the settlement mechanism for long-distance medical treatment,which should be supplemented by the improvement of relevant systems such as information construction,medical personnel training and medical compensation mechanism construction.