新型农村合作医疗中的逆向选择问题探究——基于不完全信息静态博弈模型与实证分析

Research on Adverse Selection Problem in Rural Cooperative Medical System

本文从新型农村合作医疗制度中逆向选择的概念与产生机理入手,分析了新农村合作医疗中逆向选择问题的成因,并提出了一些解决逆向选择问题的对策。逆向选择的动因和机制是十分复杂的,本文运用不完全信息静态博弈模型分析了逆向选择问题产生的内在机理及其影响因素,并运用中国健康和营养调查数据(CHNS),建立Probit模型对纳什均衡的结果进行实证分析。研究发现:农民是理性的,他们以收益最大化决定是否参加新农合,只有在农民对自己的医疗成本的估价大于政府对其医疗成本的估价时,农民才会选择参保。

Adverse selection problem in rural cooperative medical system results in serious negative influences in universal coverage and medical expenditure.The paper,based on the conception of adverse selection and mechanism,analyzes the cause of adverse selection problem and puts forward several solutions.The motivation and mechanism are complex and the paper applies the static game model with incomplete information to analyze the inherent mechanism and influence factors.Using data from China Health and Nutrition Survey(CHNS),the Probit model is used to do empirical analysis based on the result of Nash equilibrium.We find that formers are rational,and revenue maximization is the Key factor to decide farmers taking part in rural cooperative medical system.They chose to take part in rural cooperative medical system only when their evaluation of medical cost is higher than the government's.